Endocrine Abstracts

Aims and objectives: Patients with thyroid dysfunction typically require frequent monitoring of thyroid function tests in order to titrate drug treatments and achieve normal thyroid function. A nurse-led thyroid telephone consulting service was established in 2006 to allow monitoring of thyroid function tests without the need for a hospital doctor’s appointment, with the aim of offering increased convenience for patients as well as significant cost savings. This audit aims to measure the activity of the service and to estimate the costs of providing the service, in comparison to the cost of a conventional hospital clinic, as well as identify potential improvements in the design and delivery of the service.

Methods: Data were retrieved from the Thyroid Telephone Clinic referral forms for all patients referred between January 2006 and May 2008. Additional demographic and diagnostic information was retrieved from hospital IT systems when necessary. An estimated cost for running the service was calculated in terms of nurse time spent making telephone calls and performing related administration.

Results: One seventy-three consecutive patient telephone records were reviewed, covering a total of 373 consultations. 157 patients (91%) had a diagnosis of hyperthyroidism, 13 (8%) had hypothyroidism, and 3 (2%) had pituitary disease. 80% of patients referred were female, and the median age was 41 (range 18–86). The overall DNA rate for blood tests / telephone consultations was 19%. One seventy consultations (46%) resulted in a dose adjustment or change in treatment. The estimated cost of providing the service was £1135 per annum, compared to an estimated cost for conventional clinic based on a £90 tariff of £17 858 per annum.

Conclusions: A nurse-led telephone consultation service has the potential to provide significant cost savings and improved patient convenience, and to free clinic time for new patients and complex cases.