FROM THE JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
Follow-up telephone calls can significantly improve the collection of long-term patient-reported outcomes following ventral hernia repair, according to a study published online in the Oct. 20 edition of the Journal of the American College of Surgeons.
Nishant Ganesh Kumar, a medical student, and his colleagues at Vanderbilt University, Nashville, Tenn., wrote that while ventral hernia repair is one of the most common surgical procedures in the world, reliable long-term, prospective data on outcomes has been extremely difficult to collect.
“Decoupling long-term follow up from physical clinical visits offers a promising means of obtaining long-term postoperative information directly from patients through patient-reported outcomes … however, the best modality for engaging patients directly is unclear,” they wrote (J Am Coll Surg. 2016, Oct 20. doi: 10.1016/j.jamcollsurg.2016.10.031 ].
In this Plan-Do-Study-Act (PDSA) prospective study, 99 patients who had undergone ventral hernia repair were followed up by telephone, in addition to the usual email communication, 1 year after their procedure. The calls were initially made between 1:00 p.m. and 3:00 p.m. in the first phase of the study, then changed to after 3:00 p.m. in the second phase.
Compared to the long-term completion rate of 16.3% prior to the intervention – where follow-up was largely through physical clinical visits – researchers saw a completion rate of 35.7% with the telephone calls between 1:00 p.m. and 3:00 p.m., and a 55.1% completion rate after changing the call time to after 3:00 p.m. The mean participation rate was 45.4%.
Once contact was made, all the patients completed the full patient-reported outcomes assessment, although the researchers did note that some seem to experience fatigue during questioning that required the interviewers to gently steer them back to the questions.
“The advantage of making phone calls was severalfold, including clarification of survey questions to help patients with providing more insightful responses, allaying concerns of patients, and personalizing long-term follow-up, a crucial aspect missing through automated surveys,” the authors wrote.
In addition to changing the time in which the calls were made, the researchers also changed how the survey was introduced to the patients, such as referring to the survey as “follow-up,” which seemed to improve patient participation.
“Further, it was observed that during conversations with the patient, highlighting relevant features of their medical and surgical history, such as the date of the surgery, the surgeon who operated on them, and their disease progression since surgery helped in developing a rapport with the patient and increased the chances of their participation,” they reported. “With these approaches, the participation rate after the second PDSA cycle increased to 55.1%.”
The data analyses in the study were supported by the Americas Hernia Society Quality Collaborative. There were no disclosures relevant to the study.
