Telephone follow-up following office anorectal surgery.
BACKGROUND
Patients with minor anorectal conditions are frequently reviewed at an 8-week out-patient appointment (OPA). This study was designed to assess whether telephone follow-up could reduce OPA numbers whilst maintaining patient satisfaction.


METHODS
Over an 11-month period, 46 patients (23 male) underwent banding of haemorrhoids and 14 were prescribed medical treatment for fissure-in-ano (3 male). All were telephoned at 6 weeks and were offered an 8-week OPA if they had continuing problems. Patients were telephoned at a later date by a member of the hospital's patient panel to assess satisfaction.


RESULTS
Overall, 88% were contacted at 6 weeks, 60% at the first attempt; 40% required two or more attempts. Of those who underwent banding, 68% were asymptomatic, 17% requested an OPA for re-banding and 15% requested an OPA for a different problem. Of fissure patients, 25% were cured; the remainder were prescribed either second-line medical treatment (8%), anorectal physiology (42%) or surgery (25%). All avoided an OPA. Of a potential 60 OPAs, 47 were saved by telephone follow-up. None of 7 non-contactable patients accepted a written offer of an OPA. Overall, 89% of patients were contacted by the patient panel; of these patients, 93% reported a high level of satisfaction.


CONCLUSIONS
Telephone follow-up can reduce the number of OPAs following out-patient treatment of minor anorectal conditions whilst maintaining a high level of patient satisfaction. However, it requires considerable consultant time. This process could be developed into either a nurse-led service with booked telephone appointments or a patient-led service to a dedicated hotline.
Fallaize
Rebecca C
RC
Weston General Hospital, Weston-super-Mare, UK. rfallaize@doctors.org.uk
Tinline-Purvis
Christine
C
Dixon
Anthony R
AR
Pullyblank
Anne-Marie
AM
D000556:Ambulatory Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data*; D001071:Appointments and Schedules; D004739:England; D005240:Feasibility Studies; D005260:Female; D005401:Fissure in Ano / Q000601:surgery*; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008026:Ligation; D008297:Male; D017060:Patient Satisfaction; D017216:Telemedicine