Endocrine Abstracts

Aim: To evaluate the feasibility of non-face to face (NFTF) contact in the follow-up for patients with thyrotoxicosis on carbimazole therapy.

Background: While on carbimazole, achievement of a euthyroid state may involve multiple clinic appointments. We hypothesize by conducting these appointments in a NFTF setting, i.e. telephone consultation with trained nurse practitioner supported by an Endocrine consultant; a higher volume of consultations can occur at a lower cost, making the process more time and cost effective without compromising patient experience or safety.

Methodology: Patients diagnosed with thyrotoxicosis at Lincoln County Hospital from January to June 2014 were invited to partake in NFTF consultations.

Results: A total of 39 patients were recruited for the NFTF trial and sent Patient Satisfaction Questionnaires. The median number of telephone consultations was two. The compliance at the first and second NFTF contact was 69.2% and 74.4% respectively. Approximately, 85.7% of patients reported overall satisfaction with the NFTF consultation method and would be content to continue follow up in this mannerism. The patient’s answers highlighted that telephone consultations are a ‘quick way to alter dose’ and avoided ‘travelling 30 miles’ for an appointment.

Conclusion and Recommendation: Telephone consultations are an effective method of following up patients as they are safe and fit into the current shared care model. It is cost effective- according to the HRG codes published by NHS England for use in the National Reimbursement System, the cost of one NFTF is 43.50 GBP, whereas the cost of the first face to face appointment is 187 GBP in endocrinology. We recommend recruiting trained nurse practitioners to run this service; however it will be supervised by an Endocrinology consultant to ensure best patient care. This method has been adapted by Lincoln county hospital and is running successfully.