Outpatient visits versus telephone interviews for postoperative care: a randomized controlled trial

Jennifer C. Thompson, Sara B. Cichowski, Rebecca G. Rogers, Fares Qeadan, Julissa Zambrano, Cynthia Wenzl, Peter C. Jeppson, Gena C. Dunivan, Yuko M. Komesu

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Introduction and hypothesis: Our aim was to determine whether postoperative telephone follow-up was noninferior to in-person clinic visits based on patient satisfaction. Secondary outcomes were safety and clinical outcomes. Methods: Women scheduled for pelvic surgery were recruited from a single academic institution and randomized to clinic or telephone follow-up. The clinic group returned for visits 2, 6, and 12 weeks postoperatively and the telephone group received a call from a nurse at the same time intervals. Women completed the Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) questionnaire, Pelvic Floor Distress Inventory (PFDI)-20, and pain scales prior to and 3 months postoperatively. Randomized patients who completed the S-CAHPS at 3 months were included for analysis. Sample size calculations, based on a 15% noninferiority limit in the S-CAHPS global assessment surgeon rating, required 100 participants, with power = 80% and alpha = 0.025. Results: From October 2016 to November 2017, 100 participants were consented, underwent surgery, were randomized, and included in the final analysis (clinic group n = 50, telephone group n = 50). Mean age was 58.5 ± 12.2 years. Demographic data and surgery type, dichotomized into outpatient and inpatient, did not differ between groups. The S-CAHPS global assessment surgeon rating from patients in the telephone group was noninferior to the clinic group (92 vs 88%, respectively, rated their surgeons 9 and10, with a noninferiority limit of 36.1; p = 0.006). Adverse events did not differ between groups (n = 26; 57% fclinic vs 43% telephone; p = 0.36). Patients in the telephone group did not require additional emergency room or primary care visits. Clinical outcome measures improved in both groups, with no differences (all p > 0.05). Conclusions: Telephone follow-up after pelvic floor surgery results in noninferior patient satisfaction, without differences in clinical outcomes or adverse events. Telephone follow-up may improve healthcare quality and decrease patient and provider burden for postoperative care. Clinical trial registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT02891187.

Original languageEnglish (US)
Pages (from-to)1639-1646
Number of pages8
JournalInternational Urogynecology Journal
Volume30
Issue number10
DOIs
StatePublished - Oct 1 2019
Externally publishedYes

Keywords

  • Patient satisfaction
  • Postoperative care
  • Telephone visits

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Urology

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