Abstracts

Rationale: To describe existing epilepsy nurse-led telephone advice services reviewing clinical interventions during phone interactions and evaluating the cost effectiveness of such services. Methods: 3 adult and 2 paediatric neurology departments participated in an audit of all calls received over a four week period. Interventions captured were: calls necessitating discussion with the neurology team, anti-epileptic drugs titration, request of investigations, attendance at primary care, OPD or ED advice and calls generated from incoming calls. Results: Out of 787 calls received 52% required discussion with the neurology team. Increased seizure activity and medication side effects were the commonest reasons for calling. Administrative calls received were estimated at 12%. HSE tariffs estimate the cost of a single OPD appointment as €266. Processing a telephone clinic call was calculated as costing €15 per call. This audit demonstrated cost savings in the region of €103,663 during the 4 week period. Conclusions: Telephone advice facilitates changes in management for return patients which may be considerably more cost effective for the HSE and patients alike. Strategical planning is essential. These services are labour intensive, and impinge on other duties preformed by the CNSE. Electronic records may contribute to improving efficiencies in these services however, standardised procedures and a commitment to resource these services from hospital management is imperative.