title: Decision support by telephone: randomized controlled trial in a rural community setting.
abstract: OBJECTIVE
  Our community-based participatory research partnership previously evaluated Consultation Planning (CP), a question-listing intervention delivered in-person. We now report on effectiveness, cost, and value of delivering CP by telephone (Tele-CP).
  
  
  METHODS
  Between 2007 and 2010, we randomly assigned rural women with a diagnosis of breast cancer to receive Tele-CP or In-Person CP. We compared ratings of decision self-efficacy (0 minimum to 4 maximum) with a pre-specified non-inferiority margin of 15%. We also explored psychosocial and economic outcomes.
  
  
  RESULTS
  Tele-CP (n=35) recipients reported mean decision self-efficacy ratings of 3.53 versus 3.44 for in-person (n=32). Under intent-to-treat analysis, we rejected the null hypothesis of greater than 0.52 inferiority for Tele-CP (95% CI for difference: -0.44 to 0.13, p=0.006). The intervention costs averaged $48 for Tele-CP versus $78 in-person (95% CI for difference: -$63 to $2). Mean willingness-to-pay was $154 for Tele-CP and $144 for in-person (95% CI for difference: -$88 to $108).
  
  
  CONCLUSIONS
  Tele-CP was non-inferior to In-Person CP, cost no more, and was equally valued by patients.
  
  
  CONCLUSIONS
  Telephone delivery of Consultation Planning can achieve comparable quality, cost, and value as in-person. Organizations offering Consultation Planning or similar question-listing interventions should consider adopting telephone delivery.
authors: Institute for Health Policy Studies, University of California, San Francisco, CA 94118-1944, USA. jeff.belkora@ucsf.edu
authors: Jeffrey
authors: J
authors: Belkora
authors: Lauren
authors: L
authors: Stupar
authors: Sara
authors: S
authors: O'Donnell
authors: Aimee
authors: A
authors: Loucks
authors: Dan
authors: D
authors: Moore
authors: Carla
authors: C
authors: Jupiter
authors: Nancy
authors: N
authors: Johnson
authors: Leslie
authors: L
authors: Wilson
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000191:economics / Q000523:psychology*; D055812:Community-Based Participatory Research; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D003657:Decision Making; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000191:economics* / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000458:organization & administration; D012424:Rural Population / Q000706:statistics & numerical data; D020377:Self Efficacy; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013689:Telephone