Association Between Telephone Activity and Features of Patients With Inflammatory Bowel Disease  Claudia Ramos–Rivers, Miguel Regueiro, Eric J. Vargas, Eva Szigethy, Robert E. Schoen, Michael Dunn, Andrew R. Watson, Marc Schwartz, Jason Swoger, Leonard Baidoo, Arthur Barrie, Anwar Dudekula, Ada O. Youk, David G. Binion  Clinical Gastroenterology and Hepatology  Volume 12, Issue 6, Pages 986-994.e1 (June 2014) DOI: 10.1016/j.cgh.2013.11.015 Copyright © 2014 AGA Institute Terms and Conditions

Figure 1 (A) Monthly log of outgoing and incoming telephone activity recorded by nursing staff at an IBD center during 2009 and 2010. The rise in call volume corresponded with a 26% rise in the IBD center's patient population from 2475 patients in 2009 to 3118 patients in 2010. (B) Telephone activity prospectively recorded in categories by nursing staff in 2009 and 2010. (C) Distribution of IBD registry patients based on their patterns of annual telephone encounters logged in the EMR in 2009 and 2010. Patients with IBD were grouped into 4 categories: 0–1 calls per year (LTE), 2–5 calls per year, 6–10 calls per year, and >10 calls per year (HTE). (D) Distribution of total telephone encounters across the 4 categories of annual telephone encounter frequency. Patients in the LTE group were responsible for only 2% of the total number of telephone encounters in both 2009 and 2010. In contrast, patients in the HTE groups (15%–16% of the total IBD registry population [C]) were responsible for half of the telephone encounters each year. Clinical Gastroenterology and Hepatology 2014 12, 986-994.e1DOI: (10.1016/j.cgh.2013.11.015) Copyright © 2014 AGA Institute Terms and Conditions

Figure 2 Increasing annual telephone encounters in patients with IBD were associated in both 2009 and 2010 with (A) CRP elevation (P < .001), increased ESR (P < .001), prednisone use (P < .001); (B) abdominal pain (P < .001), narcotic use (P < .001), neuropsychiatric comorbidity (P < .001); and (C) poor quality of life (P < .001), ED visits (P < .001), and hospital admissions (P < .001). Clinical Gastroenterology and Hepatology 2014 12, 986-994.e1DOI: (10.1016/j.cgh.2013.11.015) Copyright © 2014 AGA Institute Terms and Conditions

Figure 3 Relationship between the maximum numbers of patients with IBD telephone encounters over 30 days and subsequent ED use and/or hospitalization over the next 12 months (Kaplan-Meier plot). Increasing telephone activity over 30 days was associated with subsequent ED use and/or hospitalization (log rank P < .001). Clinical Gastroenterology and Hepatology 2014 12, 986-994.e1DOI: (10.1016/j.cgh.2013.11.015) Copyright © 2014 AGA Institute Terms and Conditions

Supplementary Figure 1 The relationship of inflammation, chronic pain, and psychiatric comorbidity in hospitalized patients with IBD stratified by telephone activity in 2009. HTE patients with IBD who required hospitalization are shown in panel A (n = 48), and all remaining hospitalized patients in lower telephone frequency categories (non-HTE) are shown in panel B (n = 77). Venn diagrams demonstrate overlap of inflammation, chronic pain, and neuropsychiatric comorbidity in the HTE patients in 2009 (22.9%) compared with the non-HTE hospitalized patients (6.5%; P < .01). Clinical Gastroenterology and Hepatology 2014 12, 986-994.e1DOI: (10.1016/j.cgh.2013.11.015) Copyright © 2014 AGA Institute Terms and Conditions