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PubMed1998

Telephone analysis: out of sight, but not out of mind.

Past traditions and prejudices may have precluded many analysts from openly considering the use of telephone analysis as a viable treatment option. However, at times psychoanalysis by telephone may represent the best treatment available for a particular patient. Use of the telephone in clinical practice evokes complex feelings and raises a number of important issues for both patient and analyst. A case of telephone analysis is presented to illustrate the poignancy of initial telephone contact, issues associated with the decision to do psychoanalysis by telephone, some of the paradoxes and complexities of telephone work itself, and the termination process. Initial resistances by both patient and analyst are discussed, and modification of technique and its applicability to psychoanalysis in general are examined. Indicators for telephone analysis are considered.

Adult↗

PubMedDate not supplied

Cost-effectiveness of regulations against using a cellular telephone while driving.

PURPOSE: To evaluate the cost-effectiveness of regulations that prohibit using a cellular telephone while driving a motor vehicle. DESIGN: Decision analysis of risks and benefits related to cellular telephones and driving. SETTING: United States population in 1997. MEASURES: Health benefits measured as the quality-adjusted life years potentially saved. Financial benefits measured as health care and other services potentially averted. Costs of regulation measured as the lost productivity derived from willingness to pay for cellular telephone calls. RESULTS: Under base-case conditions, cellular telephone calls in the United States each day accounted for about 984 reported collisions, 1,729 total collisions, 2 deaths, 317 persons with injuries, 99 lost years of life expectancy, 161 lost quality-adjusted life years, $1 million in health care costs, and $4 million in property damage and other costs. This reflected a total of about 35 million telephone calls while driving, 70 million calling minutes, and $33 million in total value to society. The estimated cost-effectiveness ratio for a regulation restricting cellular telephone usage while driving was $300,000 per quality-adjusted life year saved, but ranged from $50,000 to $700,000 under alternative assumptions and interpretations of data. Regulations applied to teenage males could be cost-saving to society if the value of a call fell below 37 cents per minute. CONCLUSIONS: Regulations restricting cellular telephone usage while driving are less cost-effective for society than other safety measures. Nevertheless, regulations may be justifiable because the benefits and harms do not always involve the individual who has the cellular telephone. Increasing the price of a call (or adding a supplementary tax) might decrease the number of discretionary calls, be cost-saving for society, and be life-saving for individuals.

Accidents, Traffic↗

PubMed1997

The telephone as a communication medium for health education.

The telephone is being widely used by the private sector as a communication medium for understanding and influencing consumer behavior. Coinciding with the growth of telephone use in the private sector is the expansion of telephone use in health care to include complex health promotion and disease prevention interventions aimed at initiating and maintaining health-related behavioral changes. While several studies have evaluated the impact of telephone interventions on a wide range of health behaviors, no published reports synthesizing current knowledge about using the telephone as a communication medium for health education were identified. In this article, the authors therefore (1) examine recent applications of telephone use in health education by describing three example interventions, (2) outline key features and alternatives in conceptualizing and designing health education using the telephone, (3) review advantages and disadvantages of using the telephone for health education, and (4) discuss implications for health education practice and research.

Communication↗

PubMed1992

Telephone counseling improves adherence to colposcopy among lower-income minority women.

PURPOSE: A randomized trial was conducted to evaluate the impact of a telephone counseling intervention to improve patient adherence to colposcopic examination for suspected cervical intraepithelial neoplasia (CIN). METHODS: Subjects were lower-income, minority women who missed a scheduled initial appointment for colposcopy at an urban medical clinic. Patients were randomly assigned to either a control condition (n = 42) or a telephone counseling condition (n = 48). The 15-minute, structured telephone counseling intervention protocol addressed educational, psychosocial, and practical barriers to colposcopy adherence. RESULTS: The most common patient-reported barriers to colposcopy adherence included a lack of understanding of the purpose of colposcopy (50%), worry about or fear of cancer (25%), and forgetting (23%). Telephone counseling was found to be highly effective in addressing these barriers and improving adherence to diagnostic follow-up and treatment. Of patients in the control condition, 43% complied with a rescheduled colposcopy appointment, compared with 67% in the telephone counseling condition. Logistic regression analysis indicated that the effect of telephone counseling was independent of sociodemographic confounder variables (odds ratio = 2.6; P less than .003). Additionally, 74% of patients who received the initial telephone counseling adhered to recommended treatment, compared with 53% of patients in the control condition. CONCLUSION: Brief, structured telephone contact may be a cost-effective mechanism for improving adherence to diagnostic follow-up and treatment for a variety of cancer screening tests.

Adolescent↗

PubMed1998

Development and evaluation of a CD-ROM computer program to teach residents telephone management.

OBJECTIVE: Under managed care, telephone management is crucial to pediatric practice, but an effective method is needed to teach residents telephone skills. Our objective was to design an interactive CD-ROM program to teach residents an organized, consistent approach to telephone complaints and to determine whether use of the program was associated with better subsequent telephone management than reading the same information. SETTING: The general pediatric ambulatory center of a tertiary care children's hospital. PARTICIPANTS: A total of 24 PL-2 and PL-3 pediatric residents. DESIGN: A randomized, prospective, controlled comparison was conducted of resident management of two telephone calls: a 5-year-old with cough and trouble breathing, and a 7-year-old with fever. Thirteen residents were randomized to the computer group and 11 to the reading control group. Intervention. Scripts, scoring, and feedback for 10 CD-ROM-simulated calls were developed from texts and pediatrician survey using a modified Delphi technique. Volunteers acted out the caller's role in scenario scripts and were recorded onto a CD-ROM. The computer simulated calls by recognizing questions typed in a free-form format and answering with a voice response. Feedback was provided for omissions in history-taking and errors in assessment, triage, and home management. The computer group worked through the CD-ROM calls while the control group had equal time to read the same information. Evaluation Measures. A trained, standardized patient acted as the mother in pretest calls placed at the beginning of the month and posttest calls at the end. Calls were recorded and scored in a blinded manner using scoring templates and on interpersonal skills using the Patient Perception Questionnaire. RESULTS: Pretest scores for the two calls were similar in the computer versus the control group (cough, 70.33% +/- 8.36 vs 68.46% +/- 6.73; fever, 75.64% +/- 9.82 vs 73.59% +/- 9.06). Posttest scores were significantly higher in the computer group than in the control group on both calls (cough, 79.08% +/- 8.17 vs 69 +/- 13.3; fever: 83.33% +/- 9.96 vs 70.35% +/- 9.66). Interpersonal skills also were similar pretest (19 +/- 3.4 vs 20 +/- 2.7). There was modest improvement in both groups without a statistically significant difference in posttest scores (24.2 +/- 2.9 vs 22.5 +/- 3.1). CONCLUSIONS: Use of this CD-ROM telephone management program was associated with better postintervention telephone management. The program augments faculty instruction by teaching a consistent, general approach to telephone management.

CD-ROM↗

PubMed1992

Telephone versus face-to-face interviewing for household drug use surveys.

This research investigated the use of telephone versus face-to-face interviewing to gather data on the use of tobacco, alcohol, and illicit drugs. Telephone and personal drug use surveys of the 18-34 year-old household population were conducted in the state of New Jersey in 1986-1987. Survey modes were compared in terms of unit and item nonresponse rates, sample coverage, and levels of self-reported drug use. Results showed that the telephone survey achieved response rates lower than the personal survey, but comparable to telephone surveys of less threatening topics. Item nonresponse to sensitive drug questions was lower by phone than with the self-administered answer sheets in the personal mode. The exclusion of households without telephones in the telephone survey is a potential source of bias, and may lead to underestimation of alcohol and drug use for minority populations. After controlling for telephone status, the telephone survey furnished significantly lower drug use estimates on several indicators than the personal survey, with the largest mode differences found for Blacks.

Adolescent↗

PubMed1999

Concerns and confidence of general practitioners in providing telephone consultations.

BACKGROUND: In recent years the number of telephone consultations provided out of hours has increased. However, most general practitioners (GPs) have received little training in this area despite the specific skills needed to compensate for lack of visual information. Moreover, there has been no research exploring GPs' concerns and training needs in telephone consulting. AIM: To assess GPs' concerns and levels of confidence in providing telephone consultations in order to inform the development of a new training course. METHOD: Prior to attending the course, GPs were surveyed by interview or self-completion questionnaire to explore their confidence in providing telephone consultations. RESULTS: Thirty-eight GPs participated, and the sample was highly skewed towards females. The average age of participants was 42 years, 5 years less than the mean for GPs in the area. Low levels of confidence were reported by GPs in providing telephone consultations out of hours. A number of characteristics were common to telephone consultations described as difficult. The most important were lack of visual clues and lack of information about the patient, both of these were heightened in the out-of-hours period. Organizational factors leading to reduced confidence levels were also identified. CONCLUSIONS: This study demonstrates low levels of confidence among GPs conducting telephone consultations, and highlights contributing factors. Although it is not clear how far these results can be generalized, they demonstrate the need to consider telephone consulting skills training in the context of new out-of-hours arrangements. The results have been used to develop a two-day course.

Adult↗

PubMed1992

Telephone care as a substitute for routine clinic follow-up.

DESIGN: Randomized trial. SETTING: A primary care clinic. PATIENTS: Four hundred ninety-seven men aged 54 years or older. OBJECTIVE: We examined the hypothesis that substituting clinician-initiated telephone calls (telephone care) for some clinic visits would reduce medical care utilization without adversely affecting patient health. INTERVENTION: Clinicians were asked to double their recommended interval for face-to-face follow-up and schedule three intervening telephone contacts; for control patients, the follow-up interval recommended by their clinician was unchanged. MAIN OUTCOME MEASURES: Use of medical services and health status. RESULTS: During the 2-year follow-up period, 7% of patients withdrew or became unavailable. Telephone-care patients had fewer total clinic visits, scheduled and unscheduled, than usual-care patients (19%, P less than .001). In addition, telephone-care patients had less medication use (14%, P = .006), fewer admissions, and shorter stays in the hospital (28% fewer total hospital days, P = .005), and 41% fewer intensive care unit days (P = .03). Estimated total expenditures for telephone care were 28% less per patient for the 2 years ($1656, P = .004). For the subgroup of patients with fair or poor overall health at the beginning of the study (n = 180), savings were somewhat greater ($1976, P = .01). In this subgroup, improvement in physical function from baseline (P = .02) and a possible reduction in mortality (P = .06) were also observed. CONCLUSION: We conclude that substituting telephone care for selected clinic visits significantly reduces utilization of medical services. For more severely ill patients, the increased contact made possible by telephone care may also improve health status and reduce mortality.

Analysis of Variance↗

PubMed2005

The effects of telephone consultation and triage on healthcare use and patient satisfaction: a systematic review.

BACKGROUND: In recent years there has been a growth in the use of the telephone consultation for healthcare problems. This has developed, in part, as a response to increased demand for GP and accident and emergency department care. AIM: To assess the effects of telephone consultation and triage on safety, service use, and patient satisfaction. DESIGN OF STUDY: We looked at randomised controlled trials, controlled studies, controlled before/after studies, and interrupted time series of telephone consultation or triage in a general healthcare setting. SETTING: All healthcare settings were included but the majority of studies were in primary care. METHOD: We searched the Cochrane Central Register of Controlled Trials, EPOC specialised register, PubMed, EMBASE, CINAHL, SIGLE, and the National Research Register and checked reference lists of identified studies and review articles. Two reviewers independently screened studies for inclusion, extracted data, and assessed study quality. RESULTS: Nine studies met our inclusion criteria: five randomised controlled trials; one controlled trial; and three interrupted time series. Six studies compared telephone consultation with normal care; four by a doctor, one by a nurse, and one by a clinic clerk. Three of five studies found a significant decrease in visits to GPs but two found an increase in return consultations. In general at least 50% (range = 25.5-72.2%) of calls were handled by telephone consultation alone. Of seven studies reporting accident and emergency department visits, six showed no difference between the groups and one--of nurse telephone consultation--found an increase. Two studies reported deaths and found no difference between nurse telephone consultation and normal care. CONCLUSIONS: Although telephone consultation appears to have the potential to reduce GP workload, questions remain about its effect on service use. Further rigorous evaluation is needed with emphasis on service use, safety, cost, and patient satisfaction.

Controlled Clinical Trials as Topic↗

PubMed2006

A profile of communication in primary care physician telephone consultations: application of the Roter Interaction Analysis System.

BACKGROUND: Telephone consultations are a part of everyday practice, there is surprisingly little research on the subject. AIM: To describe the variation of consulting skills within a body of telephone consultations in primary care, highlighting the performance of one method of assessing the process of the consultation-- the Roter Interaction Analysis System-- with telephone consultations. DESIGN OF STUDY: Cross sectional study of 43 recordings of telephone consultations with GPs. SETTING: One rural county in the Midlands. METHOD: Recordings were made of 8 GPs, purposively selected for maximum variance in one region of the UK. Forty-three consultations were coded using the Roter Interaction Analysis System. From the descriptive categories, six composite categories were compiled reflecting a number of domains of interaction in a consultation: rapport, data gathering, patient education and counselling, partnership building, doctor dominance and patient-centredness. Analysis of variance was undertaken to explain variations between consultations for the different domains. Comparison was made to findings from similar work for face-to-face consultations. RESULTS: These telephone consultations feature more biomedical information exchange than psychosocial or affective communication. Length of interaction accounts for much of the variation seen between consultations in the domains of rapport, data gathering, patient education and counselling and partnership. Male doctors are more patient centred in this study. There is the suggestion of more doctor dominance and a less patient-centred approach when comparisons are made with previous work on face-to-face consultations. CONCLUSIONS: Although the telephone is increasingly being used to provide care, this study highlights the fact that telephone consultations cannot be taken as equivalent to those conducted face to face. More work needs to be done to delineate the features of telephone consultations.

Adult↗

PubMed1991

How well do nurse-run telephone consultations and consultations in the surgery agree? Experience in Swedish primary health care.

The telephone consultation service is an important part of Swedish primary health care. However, few studies have compared telephone consultations managed by nurses with surgery consultations managed by both doctors and nurses in terms of information obtained from the patient regarding his or her symptoms, and the management decisions made. In this study, the information obtained from a patient during a telephone consultation with a health centre nurse and the management decisions made, were compared with those obtained at a subsequent surgery consultation with the same nurse, and then with a doctor. Of 200 telephone consultations at a health centre (50 in each of the following four categories as defined by the management decision of the nurse: acute case, semi-acute case, referral case and self-care case), 193 patients were included in the study. The information given to the nurse during the telephone consultation was recorded. The patient was then asked to come for a surgery consultation on the same day, first with the same nurse and then with a general practitioner. A comparison was made between the information obtained and the decisions taken in these three situations. In 185 of the 193 cases (96%) the information led to the same management decision by the nurse, in both the telephone consultation and later in the surgery consultation. In all cases the same history was recorded by the nurse during the telephone and surgery consultations as by the general practitioner. This indicates that in most cases little or no information is missed in a telephone consultation with a nurse as compared with a surgery consultation with a nurse or doctor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1995

Survey of telephone contacts for a Regional Canadian Cancer Society District.

This is a descriptive of a census survey of telephone contacts to six unit offices of the Metro Hamilton District Canadian Cancer Society (CCS). The survey instrument was also designed to address two a priori hypotheses: that first-time contacts would be systematically different from the population of other callers; and, that some telephone contacts might represent a disguised need for emotional support. We also assessed satisfaction of CCS personnel with the outcome of telephone contacts. Over a four-day survey period, there were 946 telephone contacts of which 158 (17%) were patient related. First-time telephone contacts were more likely to be spouses or relatives/friends of patients as opposed to non-first-time contacts which were more likely to be patients (P = 0.01). A need for emotional support during telephone contact was more likely to be related to an underlying stressful prompting event for the call (P = 0.002). CCS telephone receptionist personnel were relatively less satisfied that callers' needs were met where emotional support was needed, as opposed to calls for service or information only. The results have implications for the orientation and continuing education of CCS personnel dealing with telephone contacts related to patients.

Canada↗

PubMed1997

Intervention to reduce telephone prescription requests.

OBJECTIVE: To evaluate a systematic effort to reduce telephone orders for prescription medications in a community family practice. DESIGN: Three-year intervention project. SETTING: Solo family practice in Ottawa. PARTICIPANTS: All patients requesting telephone orders for prescription medications. INTERVENTIONS: A retrospective analysis of phone requests and orders was conducted on 1 continuous year's records. A new office policy was instituted on October 9, 1992, discouraging telephone orders for prescription medication. Prescription telephone requests and orders were then monitored continuously for the next 3 years. MAIN OUTCOME MEASURES: Number of telephone prescription requests and orders per half-day 1 year before the intervention compared with the number for the 3 years after the intervention. RESULTS: One year before the intervention, there were 4.96 telephone prescription requests per half-day: 3 years after the intervention this number fell to 0.85. One year before the intervention, the number of telephone prescription orders per half-day was 4.80; this number fell continuously to 0.67 during the 3 years following the intervention. CONCLUSIONS: We observed a reduction in the number of telephone prescription requests and orders following the introduction of an office policy that encouraged prescribing and renewing medication in person.

Drug Prescriptions↗

PubMed2005

An evaluation of nurse-led rheumatology telephone clinics.

AIMS AND OBJECTIVES: The aim of the study was to examine the impact on waiting times and patient satisfaction of nurse-led rheumatology telephone clinics. METHODS: Patients awaiting outpatient review were contacted by the rheumatology clerk and offered a nurse-led rheumatology telephone appointment. Those who accepted were given a date and time for the appointment. A telephone consultation proforma was used to structure the call and to organize appropriate investigations/action. A questionnaire was mailed to the 68 patients reviewed during the first month of the telephone clinics to assess satisfaction. Status forms were also completed to record further action. RESULTS: Of the 68 patients surveyed 73% completed and returned the questionnaire. Overall 72% were happy with the telephone consultation and would be happy to use the service again. Waiting times were reduced by two months as a total of 169 patients were reviewed during the April to August period. CONCLUSION: Nurse-led telephone consultation, as part of chronic disease management, can be extremely beneficial for all rheumatology patients as a high level of satisfaction was achieved. In addition telephone consultations have helped to reduce the follow-up waiting times within the department by two months. This audit shows that telephone appointments conducted by an experienced nurse using an assessment proforma can be incorporated into routine follow-up care.

Journal Article↗

PubMed2004

Cellular telephone use among primary school children in Germany.

BACKGROUND: There is some concern about potential health risks of cellular telephone use to children. We assessed data on how many children own a cellular telephone and on how often they use it in a population-based sample. METHODS: We carried out a cross-sectional study among children in their fourth elementary school year, with a median-age of 10 years. The study was carried out in Mainz (Germany), a city with about 200,000 inhabitants. The study base comprised all 37 primary schools in Mainz and near surroundings. Altogether, 1933 children from 34 primary schools took part in the survey (participation rate of 87.8%). RESULTS: Roughly a third of all children (n = 671, 34.7%) reported to own a cellular telephone. Overall, 119 (6.2%) children used a cellular telephone for making calls at least once a day, 123 (6.4%) used it several times a week and 876 (45.3%) children used it only once in a while. The remaining 805 (41.6%) children had never used a cellular telephone. The probability of owning a cellular telephone among children was associated with older age, being male, having no siblings, giving full particulars to height and weight, more time spent watching TV and playing computer games, being picked up by their parents from school by car (instead of walking or cycling) and going to bed late. The proportion of cellular telephone owners was somewhat higher in classes with more children from socially disadvantaged families. CONCLUSIONS: Our study shows that both ownership of a cellular telephone as well as the regular use of it are already quite frequent among children in the fourth grade of primary school. With regard to potential long-term effects, we recommend follow-up studies with children.

Age Factors↗

PubMed2006

Combining conditional and unconditional recruitment incentives could facilitate telephone tracing in surveys of postpartum women.

BACKGROUND AND OBJECTIVE: To compare tracing and contact rates using alternative incentives in a computer-assisted telephone interview (CATI) survey among postpartum women. METHODS: In a randomized trial of 1,061 postpartum women 18-49 years of age selected from four Iowa counties, we compared the effects of: (1) unconditional $5 telephone card incentive enclosed with the introductory letter followed by $25 incentive conditional upon successful telephone tracing, contact, and completion of CATI (Group 1, n = 530) vs. (2) $30 incentive conditional upon subject completion of CATI (Group 2, n = 531). RESULTS: Overall telephone tracing and contact rates achieved were 67.8% and 66.6%, respectively. Tracing (70.2 vs. 65.4%, P = .09) and contact (68.5 vs. 64.8%, P = .26) rates were consistently higher among subjects assigned the combination of a conditional and an unconditional incentive. The combined incentive type had a greater impact on telephone tracing success rates for subjects on whom we could not initially locate an active telephone number (16.7 vs. 7.3%, P = .07) when compared to subjects for whom we found an active telephone number at the time of mailing the introductory letter (78.9 vs. 75.9%, P = .30). CONCLUSIONS: Combining conditional and unconditional recruitment incentives can facilitate telephone tracing efforts in surveys conducted among recently postpartum women.

Data Collection↗

PubMed2005

Digital mobile telephones and interference of ophthalmic equipment.

AIM: To assess the effect of mobile telephone electromagnetic interference on electronic ophthalmic equipment. METHODS: Prospective audit with mobile telephones placed at distances of 3 m, 1 m, and 30 cm from, and in contact with, electronic ophthalmic equipment. Any interruption or cessation of the function of the ophthalmic device was assessed with the mobile telephones in standby, and in dialling or receiving modes. Any alterations of displayed digital figures or numbers were also assessed. RESULTS: A total of 23 electronic ophthalmic devices in two hospital ophthalmology outpatient departments were evaluated. All six mobile telephones used, and 22 (95.7%) of the 23 ophthalmic equipment evaluated had the Conformité Européene (CE) mark. No device showed any interruption or cessation of function. There were no alterations of displayed digital figures or numbers. The only effect of any kind was found with four instruments (1 non-CE marked), where there was temporary flickering on the screen, and only occurred when the mobile telephones were dialling or receiving at a distance of 30 cm or less from the instruments. CONCLUSION: This study shows that among the electronic ophthalmic devices tested, none suffered failure or interruption of function, from mobile telephone interference. Although not comprehensive for all ophthalmic equipment, the results question the need for a complete ban of mobile telephones in ophthalmic departments. It highlights the need for a controlled, objectively measured study of the clinically relevant effects of mobile telephones in the ophthalmology outpatient setting.

Cell Phone↗

PubMedDate not supplied

Weekly telephone contact does not enhance the compliance of home apnea monitoring.

OBJECTIVE: To evaluate the effect of weekly telephone contact with families in enhancing the use of home apnea monitors. STUDY DESIGN: This was a prospective, randomized, single-blinded study of 65 infants who were prescribed home apnea monitoring at the time of initial discharge from the hospital. Exclusion criteria included participation in any other study involving home monitoring or nonavailability of home telephone. Infants were randomized either to the "standard" or "telephone" group by a stratified balanced block technique. All families were instructed to use the monitor during the first 4-week period at all times except during bathing and during the second 4-week period at all unattended times and at night. The families in the telephone group were contacted weekly for 8 weeks. The telephone interview reviewed the events of the previous week but did not include specific encouragement to use the monitor. Both groups received routine pediatric care and follow-up at our high-risk premature clinic. The primary outcome measure was compliance measured as the percentage of time as well as the hours per day that the infant spent on the monitor as recorded by the documented monitor. RESULTS: The telephone (n = 30) and standard (n = 32) groups were similar (p > 0.10) with respect to birth weight (1567 +/- 778 versus 1710 +/- 777 gm), gestational age (30.9 +/- 4.2 versus 31.1 +/- 4.6 weeks), maternal age (24.9 +/- 6.0 versus 25.3 +/- 5.4 years), and commercial insurance (46.7% versus 46.9%), a marker of higher socioeconomic status. Compliance of the telephone versus the standard group was similar during the first 4-week period (74.7 +/- 24.9 versus 75 +/- 27.8%, p = 0.85) (17.9 +/- 5.9 versus 18.2 +/- 6.6 hours/day), the second 4 week period (63.4 +/- 29.1 versus 58.9 +/- 30.9%, p = 0.59) (15.2 +/- 7.0 versus 14.1 +/- 7.4 hours/day) and the entire 8-week period (69.3 +/- 24.7 versus 67.7 +/- 26.2%, p = 0.82, Mann-Whitney U-test) (16.7 +/- 6.0 versus 16.1 +/- 6.5 hours/day), respectively. An abnormal pneumocardiogram at the time of discharge was the only identified factor that improved the compliance for the entire 8-week period (73.1 +/- 22 versus 52.1 +/- 28.5%, p = 0.02) (17.5 +/- 5.2 versus 12.5 +/- 6.8 hours/day) and the first 4-week period of monitoring (81.7 +/- 22.9 versus 59.5 +/- 31.3%, p = 0.01) (19.6 +/- 5.5 versus 14.2 +/- 7.5 hours/day). CONCLUSION: Weekly telephone contact, without specific encouragement to use the monitor, did not improve compliance. Compliance was greater in subjects who had abnormal pneumocardiogram results at the time of discharge from hospital regardless of their telephone/standard group assignment. We speculate that in this already compliant population, more targeted advice is necessary to increase compliance.

Apnea↗