Telephone calls have long been integral to health care delivery. Patients often contact physicians to determine whether symptoms require a face to face visit, and physicians call patients to follow up office visits. As it became increasingly clear that patient education for chronic disease requires time beyond a single office visit, telephone-based intervention became viewed as a potential effective way to overcome pragmatic obstacles (for example, space, time) to educate patients in already busy outpatient settings. Telephone contacts also provide an excellent vehicle through which to monitor patients’ health between office visits, particularly when patients need to travel long distances to receive medical care.

More than a decade ago, we began to examine the impact of proactively using telephone-based interventions for patients with osteoarthritis (OA). An uncontrolled, longitudinal study observed that, following biweekly telephone calls during a six month period, patients with OA reported significant improvements in functional status.1Perhaps more surprisingly, six months after telephone calls were ceased, improvements in functional status persisted.1

Unfortunately, this investigation lacked a control group. Thus, we conducted a randomised controlled trial to evaluate whether telephone-based or office-based interventions, or both, improved functional status of patients with OA. The intervention consisted of brief interviews during which trained non-medical personnel reviewed patients: (1) medications, (2) joint pain symptoms, (3) gastrointestinal complaints related to use of non-steroidal anti-inflammatory drugs, (4) reporting of early warning signs of hypertension, heart disease, diabetes, chronic obstructive pulmonary disease (when applicable), (5) scheduled outpatient visits, (6) an existing process by which patients could telephone a provider during evenings and weekends, and (7) barriers to …