Abstract Objective. To analyze our five-year experience with a telephone helpline service for patients suf- fering from chronic rheumatic diseases and provide the patients’ perspective derived from a dedicated survey. Methods. A telephone service (contact center) was set up in the rheumatology unit at Sapienza University of Rome, Italy, in September 2007. It is managed by operators from a medical service society who collect the patients’calls. Daily reports with medical issues are transmitted to the physicians who are supposed to call back shortly. A year after the institution of the contact center, a questionnaire was administered to a group of patients to address the level of satisfaction. Results. A total of 39,076 calls were registered between September 2007 and August 2012. Each month, an average of 20% of the calls were made by patients referring to our rheumatology unit for the first time and an average of 68.5% patients phoned to request medical consultation. Demographic analysis demonstrated a prevalence of middle-aged female patients. The majority of patients filling in the questionnaire declared an intention to use it again in the future. Further- more, 85.7% of callers reported full satisfaction with respect to the responses received to their requests. Conclusions. A telephone helpline may provide extra-clinical advice and support for patients with rheumatic diseases. Although these services cannot replace clinical appointments, they should be encouraged both to assure patients easy access to medical counseling and to optimize the daily clinical workload of physicians. http://informahealthcare.com/mor ISSN 1439-7595 (print), 1439-7609 (online) Correspondence to: Dr. Rossana Scrivo, Dipartimento di Medicina Interna e Specialità Mediche, Reumatologia - Sapienza Università di Roma - viale del Policlinico 155, 00161 Rome, Italy. Tel: + 39-06-49974640. Fax: + 39-06-49974670. E-mail: rossana.scrivo@uniroma1.it ORIGINAL ARTICLE Use of a contact center telephone helpline in rheumatology outpatient management: a five-year experience analysis and patients’ perception Rossana Scrivo 1 , Roberta Priori 1 , Mariateresa Coppola 1 , Antonina Minniti 1 , Jessica Brandt 2 , Giovanna Picarelli 1 , Valentina Cruciani 3 , Paolo Luzi 3 , and Guido Valesini 1 1 Dipartimento di Medicina Interna e Specialità Mediche, Reumatologia, Sapienza Università di Roma, Rome, Italy, 2 Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, U.S.A., and 3 Contact Center Close to Care  TOPS, Rome, Italy Keywords Patient support, Telephone helpline, Quality of care or distracting rather than helpful [14]. Furthermore, although only minor concerns were expressed regarding the skills of the persons answering the phone [9], the training and experience of the staff, which are most important when operating without visual clues and to demonstrate a clinical decision-making capa- bility, remain a matter of debate with legal implications [10, 15]. Hence, we decided to seek the support of a society specialized in health services to set up a contact center telephone service. This was handled by operators with high levels of competence in healthcare systems who were committed to organizing the gen- eral requests of the patients and to sending e-mails to the treating rheumatology practitioners according to clinical needs, relying on their expertise and knowledge of the callers. Herein we provide an analysis of our five-year experience with this service expressly developed for patients consulting the rheu- matology unit, which is the first rheumatology telephone helpline implemented in Italy. We also provide the patients’ perspective derived from a dedicated survey. Methods The contact center telephone service was set up in the rheumatol- ogy unit at Sapienza University of Rome, Italy, in September 2007. The helpline, which is still active, is managed by operators from a medical service society (Contact Center Close to Care  TOPS, Rome, Italy) that specializes in health services. The calls are collected weekly between Monday and Friday both in Mod Rheumatol, 2013; Early Online: 1–5 © 2013 Japan College of Rheumatology DOI: 10.3109/14397595.2013.844396 History Received 16 May 2013 Accepted 18 July 2013 Published online 18 October 2013 Introduction The chronic nature of most rheumatic diseases leads patients to frequently require medical advice beyond scheduled out- patient appointments. The acquiescence to these requests, when incorporated into routine medical activity, is a potential cause of distraction for the physicians. Telephone helplines, introduced in the early 1960s [1], have gained increasing application in several medical specialties [2–6] including rheumatology units [7–12]. Indeed, musculoskeletal disorders account for a high percentage of general practitioner consultations [13] and the availability of these services has been primarily utilized by the patients seeking assistance for coping with their disease [7–10]. The goal of rheumatology telephone helplines is not only to pro- vide support and information, but also to allow the patient an easy referral to a specialized team when worsening symptoms occur [8]. Indeed, patients with chronic diseases seek additional information regarding their illness, prognosis and treatment, both conventional and alternative, and they may obtain infor- mation from poorly reliable sources, such as friends, relatives, media, and the Internet [14]. However, without proper guidance, such information found by a patient may prove to be harmful Mod Rheumatol Downloaded from informahealthcare.com by AMS on 10/21/13 For personal use only.