Analysis of Unscheduled Telephone Calls Received by a Specialized Cancer Pain Nurse

Abstract

Background: A key to successful symptom management in patients with cancer is to adapt the treatment to patient needs and complexities in an individual and dynamic manner. Rapid access to a clinician via telephone consultation supports treatment compliance, safety, and effectiveness and reduces the number of patients unnecessarily consulting emergency departments.

Aims: To define the role of a cancer pain nurse in the management of unscheduled phone calls to the clinic.

Design: The study is a retrospective analysis of unscheduled phone calls received at an outpatient cancer pain clinic. Details collected included caller identification, reasons for the call, and interventions provided. Actions taken after analysis of the nature of calls are discussed.

Settings: Retrospective chart analysis.

Participants/subjects: Medical charts of patients seen at the cancer pain clinic.

Methods: During three consecutive months, 102 unscheduled telephone calls fulfilling research criteria were analyzed. Seventy-four percent were initiated by patients or carers. In 46% and 45% of the calls, respectively, the reason for the call was to report a symptom or concern about the treatment.

Results: Pain was the most common reported symptom (59.6%) followed by side effects (23.4%). The most frequent inquiry about medications concerned renewal of prescriptions (47.8%). The most common intervention was related to patients' treatments (74.5%), and it included an element of teaching in 51.3% of calls. In one third of cases, a prescription was changed after the call. The nurse was able to provide the intervention without involving a doctor in 87.3% of calls. Several changes were initiated after the analysis to decrease unnecessary calls to the nurse.

Conclusions: A telephone call service available for patients and other clinicians is an efficient way to enhance continuity of care for ambulatory patients. Continued efforts to make such a service cost effective must be implemented.