Audit of telephone HIV clinics: effective and acceptable
© Babu et al; licensee BioMed Central Ltd. 2010
Published: 8 November 2010
Purpose of the study
A Telephone HIV clinic was set up and offered to patients with chronic, stable HIV-infection to replace face-to-face appointments for three out of their four HIV reviews in a 12 month period. We initiated these telephone clinics in 2007. We audited the effectiveness and acceptability of these Clinics.
A total of 72 patients were included in the audit: 88% were male, 68% were men who have sex with men, 22% were heterosexuals of non-UK origin. This population reflects the wider patient cohort of this busy, city centre Genitourinary Medicine clinic. A retrospective case note analysis was conducted of patients seen in the telephone clinic over an 8 month period from December 2008 until July 2009. Clinic eligibility, consent documentation, compliance with recommended frequency of appointments and default rates were assessed. A patient satisfaction survey was conducted during this period.
Summary of results
Eligibility for the telephone clinic was met in 77% of cases. In the rest (23%), failure to meet inclusion criteria related to the limit set for CD4 count (N=7), viral load (N=1), previous poor appointment attendance (N=5) and outstanding contact tracing issues (N=1). Consent was documented in 82% of cases. 94% of telephone appointments were conducted within the designated time frame and the correct ratio of telephone to face-to-face appointments was achieved in 63% of instances. Overall attendance was better for the telephone clinics with only 15% of appointments failing to make contact as compared to 23% DNA rates for the equivalent face-to-face clinics. There were no cases where an urgent clinical review was needed after a telephone consultation; however, four patients were assessed in person for reasons including pregnancy, abnormal blood results and genital herpes. Overall 90% of patients scored their satisfaction as "very high".
According to standards set at inception the clinics can be considered a success with less than 1% patient dissatisfaction, greater than 90% successfully conducted telephone appointments and only one respondent indicating a preference to return to face-to-face clinics. Documentation of consent and compliance with inclusion criteria needs to be improved. However, overall telephone clinics have proven to be a convenient and effective alternative to face-to-face appointments for patients with stable HIV infection.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.