Evaluation of a telephone clinic for patients with intermittent claudication

Although the majority of patients with intermittent claudication are stable, those who develop complications can quickly deteriorate and need a rapid response. Because the majority of issues dealt with at a routine follow-up visit are in the form of a discussion, rely on symptoms and do not require an examination, it was considered appropriate to assess if a telephone follow-up service could replace these face-to-face meetings at the authors hospital. This article discusses an evaluation, the objective of which was to pilot a nurse-led telephone follow-up system for claudicant patients in terms of feasibility, patient satisfaction and impact on out-patient vascular surgery practice. This system would maintain supervision of vascular patients to enable fast-tracking into the out-patient clinic/hospital if their symptoms deteriorated. The effectiveness of the nurse-led follow up was assessed by a retrospective analysis of the out-patient clinic attendances before and after introduction of the nurse follow-up service. Attendances decreased, leading the authors to conclude that a structured follow-up system using a telephone clinic run by a skilled and specialized vascular nurse provides excellent support and effective surveillance in patients with intermittent claudication.