Development and evaluation of a clinical guideline for a paediatric telemedicine service in a low-resource setting.

OBJECTIVE: To develop and evaluate a guideline for a paediatric telemedicine and medication delivery service (TMDS). METHODS: A clinical guideline for paediatric telemedicine was derived from the World Health (WHO) Organization Integrated Management of Childhood Illness (IMCI) Handbook. The guideline was deployed at a TMDS in Haiti and evaluated through a prospective cohort study; children ≤10 years were enrolled. For non-severe cases, paired virtual and in-person examinations were conducted at the call centre and household; severe cases were referred to the hospital. The performance of virtual examination components were evaluated by comparison with the paired in-person examination findings (reference). RESULTS: A total of 391 cases were enrolled. Among the 320 cases with paired examinations, no general WHO danger signs were identified during in-person examinations; 5 cases (2%) required hospital referral due to problem-specific danger signs or other reasons for escalation. Cohen's kappa for the virtual designation of mild cases was 0.78 (95% CI: 0.69 to 0.87). The sensitivity and specificity of a virtually reported fever were 91% (95% CI: 87% to 96%) and 69% (95% CI: 62% to 76%), respectively; the sensitivity and specificity of virtually reported 'fast breathing' were 47% (95% CI: 21% to 72%) and 89% (95% CI: 85% to 94%), respectively. Kappa for 'no' and 'some' dehydration indicated moderate congruence between virtual and in-person examinations (0.69; 95% CI: 0.41 to 0.98). At 10 days, 273 (95%) of the 287 cases reached by phone were better/recovered. CONCLUSION: Critical components of the virtual examination (triage, danger signs and dehydration assessment) performed well despite varied performance among the problem-specific components. The study and associated resources represents formative steps towards an evidence-based paediatric telemedicine guideline built on WHO clinical principles. In-person examinations for select cases were important to address limitations with virtual examinations and identify cases for escalation. TRIAL REGISTRATION NUMBER: NCT03943654.

The MeSH heading "Call Center" is due for an update: why we recommend the more precise heading "Emergency Medical Communication Center".

Call centers can be found in various industries. However as a Medical Subject Heading (MeSH) the term "Call centers" does not reflect the critical purpose of handling emergency calls. We recommend "emergency medical communication center(s)", as this provides clarity and precision regarding the primary function and purpose of the center.

[The functioning of call-center in conditions of COVID-19 pandemic].

In conditions of persisting high morbidity of COVID-19, issues related to prompt and timely medical care of population remains actual ones. The purpose of the study to analyze activities of the call-center of the Ministry of Health Care of the Udmurt Republic related to organization of medical care of COVID-19 patients in the Udmurt Republic. MATERIALS AND METHODS: The statistical (descriptive statistics) and descriptive methods were applied. The indicators of functioning of the call-center of the Ministry of Health Care of the Udmurt Republic in 2020-2022 were analyzed. The psychological characteristics of telephone counseling were studied. The satisfaction of medical organizations and citizens with services of call-center operators was assessed. THE RESULTS: The main principles of telephone counseling are confidentiality, maintenance of framework of working conversation, respect to personality of addressee. In 2020 the call center phone line received 34160 calls, in 2021 - 128339 calls, in 2022 - 65618 calls. In 25 months of operation the call-center operators received 228,117 calls from citizens related to issues of new coronavirus infection. The number of patient calls to the hot-line increases significantly when incidence of new coronavirus infection increases (r=0.885; p<0.05). Most frequently (25.1%) citizens contacted the call-center of the Ministry of Health Care of the Udmurt Republic due to inability to reach the polyclinic and on issues related to primary before-doctor care. The second place in terms of frequency (18.5%) took issues related to PCR-test results. The third place (14.1%) took issues related to duration of quarantine for patients and persons residing with them, possibility for children to attend preschool and educational institutions. The number of outgoing calling in 2020 was 16146, in 2021 - 89269 and in 2022 9936 calls. During 25 months of operation, call-center operators made 204,782 calls to citizens to monitor their health status and invite them to vaccinations and health screenings. More than half of outgoing calls (58.3%) were related to audio-monitoring of patients undergoing outpatient treatment with making-up of electronic protocol. CONCLUSIONS: During the period of increasing of COVID-19 morbidity, the call-center becomes an independent structural unit of organizing patient care. The medical organizations and citizens are satisfied with functioning of the call-center of the Ministry of Health Care of the Udmurt Republic organized in order of improving the organization of medical care of patients with COVID-19.

Predictive factors for early requirement of respiratory support through phone call to Emergency Medical Call Centre for dyspnoea: a retrospective cohort study.

BACKGROUND: Acute dyspnoea is a common symptom in Emergency Medicine, and severity assessment is difficult during the first time the patient calls the Emergency Medical Call Centre. OBJECTIVE: To identify predictive factors regarding the need for early respiratory support in patients who call the Emergency Medical Call Centre for dyspnoea. DESIGN, SETTINGS AND PARTICIPANTS: This retrospective cohort study carried out in the Emergency Medical Call Centre of the University Hospital of Toulouse from 1 July to 31 December 2019. Patients over the age of 15 who call the Emergency Medical Call Centre regarding dyspnoea and who were registered at the University Hospital or died before admission were included in our study. OUTCOME MEASURE AND ANALYSIS: The primary end-point was early requirement of respiratory support [including high-flow oxygen, non-invasive ventilation (NIV) or mechanical ventilation after intubation] that was initiated by the physicians staffed ambulance before admission to the hospital or within 3 h after being admitted. Associations with patients' characteristics identified during Emergency Medical Call Centre calls were assessed with a backward stepwise logistic regression after multiple imputations for missing values. MAIN RESULTS: During the 6-month inclusion period, 1425 patients called the Emergency Medical Call Centre for respiratory issues. After excluding 38 calls, 1387 were analyzed, including 208 (15%) patients requiring respiratory support. The most frequent respiratory support used was NIV (75%). Six independent predictive factors of requirement of respiratory support were identified: chronic ß2-mimetics medication [odds ratio (OR) = 2.35, 95% confidence interval (CI) 1.61-3.44], polypnea (OR = 5.78, 95% CI 2.74-12.22), altered ability to speak (OR = 2.35, 95% CI 1.55-3.55), cyanosis (OR = 2.79, 95% CI 1.81-4.32), sweats (OR = 1.93, 95% CI 1.25-3) and altered consciousness (OR = 1.8, 95% CI 1.1-3.08). CONCLUSION: During first calls for dyspnoea, six predictive factors are independently associated with the risk of early requirement of respiratory support.

A cross-sectional study on factors affecting the intention to quit smoking among female call centre employees.

AIM: This study aims to describe smoking related characteristics among female call centre employees in South Korea and identify the factors influencing intention to quit smoking in the next 6 months. DESIGN: This is a cross-sectional study. METHODS: An anonymous online survey was conducted at three call centres of credit card companies in South Korea. Female employees with at least 6 months of experience (n = 115) who were currently smoking were included in this study. RESULTS: Overall, 20% of participants intended to quit within 6 months. Female call centre employees find it most difficult to resist the urge to smoke in negative mood situations. Factors affecting the quit intention were higher educational status, previous quit attempts lower perceived risk of craving and higher social support. PUBLIC CONTRIBUTION: Measuring and monitoring craving as perceived risk and providing social support can be useful for designing smoking cessation interventions in this population.

Feasibility and preliminary results of a call centre delivered continuing care intervention following residential alcohol and other drug treatment.

INTRODUCTION: To help reduce relapse rates following alcohol and other drug (AOD) treatment, continuing care interventions have been recommended. Previous continuing care interventions have incorporated telephone and face-to-face sessions to help promote participant engagement. The study was conducted as a randomised controlled feasibility study and examined a call centre delivered continuing care intervention for people leaving residential rehabilitation services. METHODS: Participants were attending AOD residential treatment services in NSW, Australia (N = 154). Participants were randomised to either 12- or 4-sessions of continuing care. Follow up assessments were completed at 6-months. The primary outcomes were demand and implementation. Secondary outcomes were AOD use, mental health and physical health at 6-months. RESULTS: Interest in continuing care was high, with 93% of participants approached reporting an interest in being involved. Of the participants who completed the consent and baseline procedures, 29% of people were contacted post residential treatment and randomised. For those people randomised, the average number of sessions completed was 2.78 (SD = 1.65) for the 4-session arm and 4.81 (SD = 4.46) for the 12-session arm. Fidelity to the treatment manual was high. Both treatment arms showed higher complete abstinence at 6-months compared to baseline (12-session OR 28.57 [2.3, 353.8]; 4-session OR 28.11 [3.6, 221.2]). DISCUSSION AND CONCLUSIONS: A major challenge associated with the call centre approach was re-engaging participants once they left the residential facility and delivering the planned dose of treatment. Further work is required to promote greater uptake of these protocols once people leave residential treatment.

Using an Exposure Call Center to Help Mitigate Outbreaks, Such as COVID-19, on a University Campus.

Rapid identification and management of close contacts is an important component of an effective university mitigation strategy for highly contagious infectious diseases such as measles and coronavirus disease-2019 (COVID-19). Institutions of higher education must plan for an associated large influx of calls that can overwhelm standard student health and local public health operations. In fall 2020, a large state public university's Department of Student Health and Wellness created a dedicated exposure call center (ECC), in close collaboration with the local public health department, to quickly assess students who learned of a COVID-19 exposure outside of the formal contact tracing process. The ECC operated 7 days a week and fielded 3361 calls: 3187 from students and 174 from staff, faculty, and parents. The ECC provided rapid assessment and guidance for students with COVID-19 exposure, allowing for prompt quarantine and medical assessment when warranted. Call centers can increase the bandwidth of university health centers and also reduce the burden on health care providers and other public health resources during periods of crisis or high demand.

Emergency calls from migrants to an emergency call centre: A retrospective epidemiological study.

OBJECTIVE: The study aims to evaluate migrants' inclination to call emergency call centres. Records of calls made to an emergency call centre by migrants of different age groups and nationalities were reviewed retrospectively. MATERIALS AND METHODS: A total of 4481 emergency call records from migrants of 33 different nationalities was evaluated between 2017 and 2021. RESULTS: Migrants called the emergency call centres mostly for medical reasons, and most of their calls resulted in referrals to hospitals. Pain, fever, nausea, and vomiting were among the most common medical reasons for emergency calls. The majority of the calls were in the green triage category, and the calls spread over the week. CONCLUSION: The results showed that migrants use emergency call services in non-emergency situations. The study recommended enhancing migrants' knowledge of when and how to utilise emergency call centres and making health planning to meet their specific needs.

Investigating the distribution of calls to a North American animal poison control call center by veterinarians and the public in space, time, and space-time.

Health assessments via phone call or tele-triage have become very popular. Tele-triage in the veterinary field and North American context is available since the early 2000s. However, there is little knowledge of how caller type influences the distribution of calls. The objectives of this study were to examine the distribution of calls to the Animal Poison Control Center (APCC) by caller type in space, time, and space-time. Data regarding caller location were obtained from the APCC by American Society for the Prevention of Cruelty to Animals (ASPCA). The data were analysed using the spatial scan statistic to identify clusters of higher-than-expected proportion of veterinarian or public calls in space, time, and space-time. Statistically significant spatial clusters of increased call frequencies by veterinarians were identified in some western, midwestern, and southwestern states for each year of the study period. Furthermore, annual clusters of increased call frequencies by the general public were identified from some northeastern states. Based on yearly scans, we identified statistically significant temporal clusters of higher-than-expected public calls during Christmas/winter holidays. During space-time scans of the entire study period, we identified a statistically significant cluster of higher-than-expected proportion of veterinarian calls at the beginning of the study period in the western, central, and southeastern states followed by a significant cluster of excess public calls near the end of the study period on the northeast. Our results suggest that user patterns of the APCC vary by region and both season and calendar time.

Prevalence of night eating syndrome among inbound call centre employees in Kuala Lumpur, Malaysia.

Background: Night eating syndrome (NES) is described as a disordered eating pattern relative to sleep, where consumption of food occurs in the evening and night. Numerous studies had been conducted in various populations but studies on (NES) among call centre employees are limited. Aim: This study aimed to determine the prevalence of NES and its determinants among selected inbound call centre employees in Kuala Lumpur, Malaysia. Methods: In this cross-sectional study, a total of 217 inbound call centre employees were recruited through random sampling. A self-administered socio-demographic and work-related questionnaire was used to collect data on the background of the respondents. Information on NES and well-being was obtained by using the Night Eating Questionnaire (NEQ) and World Health Organisation-Five Well-Being Index (WHO-5) respectively. Data on dietary intakes, smoking habits, alcohol intakes and life stress were acquired using a Simple Lifestyle Indicator Questionnaire (SLIQ) while eating behaviour of the respondents was studied using the Three-Factor Eating Questionnaire (TFEQ-18). Results: The mean age of the respondents was 24.1 ± 6.0 years. The prevalence of NES was 12.0% (95% CI = 8.12-17.24). The binary logistic regression identified that NES is significantly associated with adequate exercise (AOR = 4.250, p = 0.012) and emotional eating (AOR = 6.510, p = 0.014). Conclusion: This study showed that the prevalence of NES was high in the call centre and repeated nocturnal eating can have multiple adverse health effects. Therefore, promoting healthy eating habits are crucial to reduce the impacts of NES.

Preventing Homelessness Through the National Call Center for Homeless Veterans: Analysis of Calls and Service Referrals.

OBJECTIVE: This study was the first to examine the characteristics and referral outcomes for veterans calling the National Call Center for Homeless Veterans (NCCHV). METHODS: The authors analyzed data from NCCHV and U.S. Department of Veterans Affairs (VA) health care records. RESULTS: Between December 2018 and October 2020, the NCCHV received 266,100 messages, with no major increase in the first 6 months of the COVID-19 pandemic. Of 110,197 veterans who contacted NCCHV, 69.6% were at risk for homelessness, and 20.1% were homeless. Most contacts (90.2%) resulted in a referral or transfer to a local resource. About 59.5% of NCCHV veterans had a medical record in the Veterans Health Administration; their use of homeless programs increased from 25.9% to 81.3%. Uses of mental health services, substance use treatment, and medical services showed small-to-moderate increases after NCCHV contacts. CONCLUSION: NCCHV is important for linking veterans to health and social care. Additional work is needed to assess veterans' outcomes after an NCCHV contact.

Examining the differential use of a North American animal poison control call center by veterinarians and the public for dog-related calls.

Tele-triage, a subset of telehealth services, is becoming increasingly common, they offer users the ability to receive credible health advice from licensed professionals in the comfort of their own home. In the field of veterinary medicine, tele-triage services have been employed since the early 2000s, but there has been little examination of how these services are used by callers. The objectives of this study were to explore how the use of an animal poison control center (APCC) tele-triage service varied between veterinarians and the public in terms of toxicant type, animal demographics, availability of veterinary services, as well as seasonal and secular trends. Data regarding dog poisoning events were obtained from the APCC of the American Society for the Prevention of Cruelty to Animals' (ASPCA). We fitted a mixed logistic regression model with random intercepts for county and state and identified associations between caller type and the following: animal characteristics (i.e., age, weight, breed-class), type of toxicant, season, year, and access to veterinary services (i.e., veterinarians per capita in the county of the caller). The model included interaction effects between season and both plant and pesticide toxicants. There was also an interaction between year and access to veterinary care. Further investigations are needed to understand how the novelty of a toxicant and the severity of clinical signs associated with a toxicant predict the type of caller, if pet demographics are associated with the caller based on medical issues or owner attitudes, and how access to veterinary care influences the use of this tele-triage service.

Utility of prehospital call center ambulance dispatch data for COVID-19 cluster surveillance: A retrospective analysis.

INTRODUCTION: Cluster surveillance, identification, and containment are primary outbreak management techniques; however, adapting these for low- and middle-income countries is an ongoing challenge. We aimed to evaluate the utility of prehospital call center ambulance dispatch (CCAD) data for surveillance by examining the correlation between influenza-like illness (ILI)-related dispatch calls and COVID-19 cases. METHODS: We performed a retrospective analysis of state-level CCAD and COVID-19 data recorded between January 1 and April 30, 2020, in Telangana, India. The primary outcome was a time series correlation between ILI calls in CCAD and COVID-19 case counts. Secondarily, we looked for a year-to-year correlation of ILI calls in the same period over 2018, 2019, and 2020. RESULTS: On average, ILI calls comprised 12.9% (95% CI 11.7%-14.1%) of total daily calls in 2020, compared to 7.8% (95% CI 7.6%-8.0%) in 2018, and 7.7% (95% CI 7.5%-7.7%) in 2019. ILI call counts from 2018, 2019, and 2020 aligned closely until March 19, when 2020 ILI calls increased, representing 16% of all calls by March 23 and 27.5% by April 7. In contrast to the significant correlation observed between 2020 and previous years' January-February calls (2020 and 2019-Durbin-Watson test statistic [DW] = 0.749, p < 0.001; 2020 and 2018-DW = 1.232, p < 0.001), no correlation was observed for March-April calls (2020 and 2019-DW = 2.012, p = 0.476; 2020 and 2018-DW = 1.820, p = 0.208). In March-April 2020, the daily reported COVID-19 cases by time series significantly correlated with the ILI calls (DW = 0.977, p < 0.001). The ILI calls on a specific day significantly correlated with the COVID-19 cases reported 6 days prior and up to 14 days after (cross-correlation > 0.251, the 95% upper confidence limit). CONCLUSIONS: The statistically significant time series correlation between ILI calls and COVID-19 cases suggests prehospital CCAD can be part of early warning systems aiding outbreak cluster surveillance, identification, and containment.

[Evaluation of a clinical orientation Call Center during the first months of the COVID-19 pandemic]. / Evaluación de un call center de orientación clínica durante los primeros meses de pandemia COVID-19: capacidad de resolución de los llamados.

BACKGROUND: During sanitary emergencies such as the recent pandemic, health services can collapse. In these cases, remote orientation services such as call centers may help to debottleneck these services. AIM: To assess the demand and problem resolution of a clinical guidance telephone service during the COVID-19 pandemic. MATERIAL AND METHODS: The call registry between May and August 2020 of an orientation call center for COVID-19 was analyzed. The number of calls, sociodemographic features of callers, type of enquiry and given indications were described. RESULTS: We analyzed 1,278 telephone calls, corresponding to 655 people. Sixty nine percent of queries were resolved during the call and in 31% of calls, users were referred to face-to-face evaluation. Two percent of these referrals were to an emergency service. CONCLUSIONS: The call center had a high level of resolution, favoring remote consultation and reducing face-to-face care, improving users'accessibility.

Profile of serious angioedema requiring an urgent advice from a national reference call center.

Angioedema (AE) is a reason for emergency care when it is severe. Care is difficult when the diagnostic is not known before the attack: mast cell (MC) or bradykinin (BK) mediated. One is very common but often benign, the other rare but potentially fatal. The French national reference center of angioedema (CREAK) provides emergency physicians with a hotline and a guideline to help them manage their patients. This study aimed to describe the clinical features of AE episodes prompting a call on the CREAK hotline and classify patients depending on the suspected cause of the AE. This is a retrospective study between March and August 2019. Each physician calling on the CREAK hotline was asked to fill a clinical description form for the AE emergency. Known patients of CREAK was excluded. Eighty four patients were included. Forty one (48.8%) in the angiotensin converting enzyme inhibitors induced acquired angioedema (ACEi-AAE), 39 (46.4%) in the mast cell induced angioedema, and 4 (4.8%) in the Bradykinin mediated angioedema. The mast cell induced angioedema patients have more history of hives (29.3%) than ACEi-AAE (2.4%, P = .0004). ACEi-AAE mainly affected the tongue (58.5% vs 25.6%, P = .003) and larynx (29.3% vs 13%, P = .001). In 65.5% of cases, the etiological diagnosis was not mentioned by the appellant, but made by the hotline. In 31% of cases, the hotline suggested the administration of a specific treatment not previously provided by the caller. All the doctors who called the hotline appreciate this tele-expertise especially in case of ACEi-AAE presumptions. In addition to providing rapid AE expertise, this service also allows to educate physicians in the management of AE irrespective of its origin.

COVID-19 Fear, Health Behaviors, and Subjective Health Status of Call Center Workers.

BACKGROUND: Fear may be critical in explaining individual and social behaviors. This study investigates the association between COVID-19 fear and health behavior and subjective health status changes of call center workers in the COVID-19 era. METHODS: This cross-sectional study uses an online survey with 339 call center workers. We measured COVID-19 fear, health behaviors, and subjective health, and analyzed with the Macnemar or paired t-test, ANOVA or χ2 test, Scheffe's test, and multiple linear regression. RESULTS: COVID-19 fear was associated with poor stress management, shorter sleep hours, and binge eating. Moreover, COVID-19 fear and time pressure at work were negatively associated with subjective health status. CONCLUSION: Strengthening the support system for call center workers to manage the COVID-19 fear might be essential. Moreover, there is a need to improve dense environments and reduce time pressure by ensuring adequate rest time and increasing physical activity.

Smoking in the workplace: A study of female call center employees in South Korea.

Smoking among women is characteristically high among call center employees and is associated with various individual and work-related characteristics, which have been paid little attention so far. This study explored the differences in intrapersonal and interpersonal characteristics and environmental factors among Korean women working in call centers by smoking status, based on an ecological model. In this cross-sectional study, an anonymous online survey was conducted among a sample of female employees from three credit card-based call centers (N = 588). Differences in intrapersonal (social nicotine dependence, smoking attitudes, emotional labor), interpersonal (smoking among family or friends, social support), and environmental factors (smoking cessation education, and perceived and preferred smoking policy at work) were compared according to smoking status (smokers, ex-smokers, and never smokers). Approximately 20% (n = 115) were smokers. Smokers were younger, mostly unmarried, had lower education, and had poorer perceived health status than ex- and never smokers. The mean scores for social nicotine dependence and smoking attitude were the highest among smokers, indicating their tendency to underestimate the negative effects of smoking. They also reported the highest level of emotional labor, with about half (50.4%) and almost all (95.7%) reporting smoking behaviors in their families and friends, respectively. Smokers took a lenient stance on the smoking ban policy. The results indicated the necessity to develop tailored smoking cessation programs to motivate female call center employees to quit smoking. As call centers may have a smoking-friendly environment, comprehensive smoking prevention programs considering multilevel factors are required to support smoking cessation.

Occupational diseases among call center operators needing vocal rehabilitation.

BACKGROUND: Work related diseases (WRDs) and occupational diseases (ODs) greatly affect call center operators (CCOs) who experience demanding work expectations and adverse working conditions in their workplace. The aim of this study was to evaluate the sociodemographic and job characteristics of CCOs diagnosed with OD, and to describe the changes in employment status after diagnosis. METHODS: This descriptive study is based on the electronic data records of Istanbul Occupational Diseases Hospital available from February 2007 to March 2018. RESULTS: According to the health board reports, 122 of the 173 (70.5%) CCOs had a confirmed OD diagnosis, 85.2% were females and the mean age was 27.5 years. Vocal cord disorders were the most frequent ODs (64.8%), followed by hearing loss (12.5%), dysphonia (10.2%) and temporomandibular disorders (4.7%). Vocal cord nodules (VCN) were found to be more frequent among females compared to males (92.9% vs 62.4%, p<0.001). Although not statistically significant, the frequency of VCN was also higher in subjects working overtime (14.6% vs 6.3%), having gastroesophageal reflux disease (82.3% vs 73.9%) or thyroid nodules (100% vs 73.7%) and being current smokers (41.7% vs 13.3%). Following the OD diagnosis, 43.8% of the cases were dismissed, 18.7% quit their job, and 9.4% still held the same job position. Only 28.1% changed unit within the workplace. CONCLUSION: Including the CCOs who were diagnosed with an OD at a very young age and at an early stage of their working life into vocational rehabilitation programs and employing them under appropriate conditions is essential to proper health and safety protocol.

Virtualization and standardization of a health-system specialty pharmacy call center.

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic provided an opportunity to change how health-system specialty pharmacy (HSSP) call center operations are organized. This article describes the steps taken to virtualize the current operations of a specialty pharmacy services call center and evaluate the impact. SUMMARY: The onset of the COVID-19 pandemic and its impact on the normal provision of healthcare necessitated that HSSPs drastically modify existing procedures to both accommodate the expectations of staff and overcome the many barriers to care being experienced by patients. To fully understand and improve upon the workflow processes of an HSSP call center, a combination of qualitative feedback from patients, quantitative claims data, and quality metrics was evaluated. This project was divided into 3 phases: phase 1 (baseline) from July 2020 through August 2020, phase 2 (implementation) from September 2020 through December 2020, and phase 3 (analysis) from January 2021 through March 2021. Phase 1 included baseline review of workflow. Phase 2 encompassed development of new standard operating procedures (SOPs), making critical decisions to promote virtual capabilities of staff, and collaboration with team members to increase efficiency of current workflow. During phase 3, an evaluation of operational and service-related metrics was conducted to determine the impact of phase 2 workflow changes. Optimization of the specialty pharmacy call center allowed for staff members to transition to remote work to minimize exposure risk and prioritize the safety of patients and team members. CONCLUSION: The call center team was able to transition to fully remote operations, implement new SOPs, and undergo significant workflow changes to optimize performance while still maintaining all call center metric goals and without increased complaints from patients or errors. This approach allowed for added staff value and safety and improved organization during the COVID-19 pandemic.

Patient concerns regarding antidepressant drug–drug interactions: a retrospective analysis using data from a medicines call centre.

Introduction Antidepressant use has increased over the last two decades, with Australia and New Zealand among the highest antidepressant users in Organisation for Economic Co-operation and Development (OECD) countries. Comorbidity and polypharmacy are common in antidepressant users, increasing the likelihood of interaction-related adverse drug events, which are frequently preventable. Aim We aimed to identify, profile, and analyse potential antidepressant drug-drug interactions in information-seeking antidepressant users. Methods We retrospectively analysed antidepressant-related drug-drug interaction enquiries from patients or carers who contacted a pharmacist-led Australian national medicines call centre over an 8-year period to determine patient characteristics, concomitant drugs involved, prevalence and type of antidepressant-related drug-drug interaction across life stages, and associated risks. Results Of 3899 antidepressant drug-drug interaction calls, the most frequent concomitant drugs were antipsychotics, opioids, benzodiazepines, and complementary medicines. Narrative analyses of 2011 calls identified 81.0% of patients with potential drug-drug interactions and 10.4% categorised with worrying symptoms. The most frequent drug-drug interaction risks were excessive sedation, increased anticholinergic effects, serotonin syndrome, and suicidal thoughts. Carers of children aged Discussion Antidepressant users often have information gaps and safety concerns regarding drug-drug interactions that motivate help-seeking behaviour. Symptoms and drug-drug interaction consequences may be underestimated in these patients. Primary care health professionals have a role in proactively addressing the risk of drug-drug interactions to support benefit-risk assessment and shared decision-making.