Introduction and Objective: Type 2 diabetes care is underpinned by patient education, evidence-based therapy, complication surveillance and timely intervention. Patients sometimes need urgent specialist advice to prevent emergency room (ER) and extra outpatient (OP) attendance and for reassurance. We offer OP care, website support, and 3 lines: Emergency Advice Line (EAL) - immediate specialist advice 8AM - 10PM weekdays and 8AM - 4PM weekends, and Non-urgent Patient/Carer (NU-P) and Non-urgent Clinician (NU-C) advice within 24-hr. Objective - to assess impact of clinical support lines on ER and extra OP attendance.
Methods: We assessed line activity and impact October 2021 to November 2023 in 5,809 contacts (mean 232 pcm): EAL (452 [7%]) - 18 pcm, NU-P (2531 [44%]) - 101 pcm and NU-C (2826 [49%]) - 113 pcm. After contact, diabetes specialists gauged whether consultation likely prevented ER or extra OP attendance. We used hospital records to test specialist judgements in 100 consecutive patients and found specialists accurately predicted 28-day ER prevention and OP referral prevention in 98% and 93% patients respectively.
Results: For EAL, 75% calls were patients and carers and 25% non-specialist clinicians. Over 25-months, EAL calls fell 17%, but NU-P and NU-C grew by 63% and 36% respectively.
Conclusion: Timely advice and reassurance are invaluable, but our experience suggests advice lines may also prevent ER and extra OP attendances.
G.A. Lewis: None. L.J. Mitchell: None. K.J. Hardy: Other Relationship; AstraZeneca, Sanofi.
