The Effectiveness and Cost-effectiveness of Medical Advice Given by Telephone for Patients Calling for Primary Care

NCT02286245 | Completed

• 2 other identifiers: K1201042013-AO1722-43
• Study Type: interventional
• Target: 2,498
• Locations: 1 country
• Sites: 1

Brief Summary

Telephone medical advice in general practice is expanding. The Cochrane Database concludes in 2008 that there is not enough data about its use regarding out-of-hours general practitioners workload, emergency department visits, cost, safety and patient satisfaction. The aim of this study is to assess the effectiveness of telephone medical advice given by a general practitioner in a call centre for patient presenting isolated fever or gastroenteritis symptoms.

Conditions

Isolated Fever; Gastroenteritis Symptoms

Keywords

Triage; Hotline; Primary Health Care; Emergency Medical Service Communication Systems

Outcome Measures

Primary Outcomes (1)

• Proportion of patient with physical consultation by a general practitioner or in an emergency department, during out-of-hours periods

  Proportion of patient with physical consultation by a general practitioner or in an emergency department, during out-of-hours periods

  at 15 days

Secondary Outcomes (14)

• Cost effectiveness

  at 15 days

• Care Mobile Units use

  at 15 days

• Emergency Medical Service use

  at 15 days

• Firemen use

  at 15 days

• Recall at dispatching centre

  at 15 days

Study Arms (2)

1: focused Telephonic Medical Advice

EXPERIMENTAL

The physician will implement a protocol of care to each patient call for an isolated fever and/or symptoms of gastroenteritis: medical advice, drug prescription by phone and supervisory board. Patients are invited to recall in case of worsening or onset of new symptoms and to get an appointment with their general practitioner during working hours.

Other: focused Telephonic Medical Advice

2: Usual practice

ACTIVE COMPARATOR

The physician will decide for the same disease (isolated fever and/or symptoms of gastroenteritis) the need of telephone advice with or without drug prescription, home visit by a doctor, emergency department services with or without EMS system.

Other: Usual practice

Interventions

focused Telephonic Medical Advice OTHER

The physician will implement a protocol of care to each patient call for an isolated fever and/or symptoms of gastroenteritis: medical advice, drug prescription by phone and supervisory board

1: focused Telephonic Medical Advice

Usual practice OTHER

The physician will decide for the same disease (isolated fever and/or symptoms of gastroenteritis) the need of telephone advice with or without drug prescription, home visit by a doctor, emergency department services with or without EMS system.

2: Usual practice

Eligibility Criteria

• Age: 1 Year+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Disease:
• Fever: temperature ≥ 38 ° C
• Symptoms of gastroenteritis include nausea and / or vomiting and / or diarrhea
• Onset of symptoms for less than 72 hours
• Age ≥ 18 years caller
• Patient age ≥ 1 year
• Affiliation to the French National Health Service

You may not qualify if:

• Pregnancy
• Severity criteria (fever\> 41 ° C, disturbance of consciousness, rash, dyspnea, signs of dehydration, chest pain, neurological signs, gastrointestinal bleeding)
• Seeking advice from institutional correspondents (fire brigade, police, airport…)
• Communication difficulties (non-communicating patient, language barrier...)

Sponsors & Collaborators

• Assistance Publique - Hôpitaux de Paris: lead

Study Sites (1)

SAMU 93 - EA 3409 - Faculté de Médecine de Bobigny - Université Paris 13

Bobigny, Île-de-France Region, 93009, France

Location

Related Publications (2)

• Reuter PG, Durand-Zaleski I, Ducros O, Grignon O, Megy-Michoux I, Sourbes A, Desmettre T, Javaud N, Lapostolle F, Vicaut E, Adnet F. Efficacy of emergency medical center use of a protocol during telephone calls to give medical advice related to fever or gastroenteritis: a cluster randomized controlled trial. Emergencias. 2021 Aug;33(4):292-298. English, Spanish.

  PMID: 34251142 DERIVED

• Reuter PG, Desmettre T, Guinemer S, Ducros O, Begey S, Ricard-Hibon A, Billier L, Grignon O, Megy-Michoux I, Latouff JN, Sourbes A, Latier J, Durand-Zaleski I, Lapostolle F, Vicaut E, Adnet F. Effectiveness and cost-effectiveness of telephone consultations for fever or gastroenteritis using a formalised procedure in general practice: study protocol of a cluster randomised controlled trial. Trials. 2016 Sep 22;17(1):461. doi: 10.1186/s13063-016-1585-9.

  PMID: 27659897 DERIVED

Study Officials

• Frédéric ADNET, MD, PhD

  Assistance Publique - Hôpitaux de Paris

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 9, 2014
• First Posted: November 7, 2014
• Study Start: March 1, 2015
• Primary Completion: September 1, 2016
• Study Completion: September 1, 2016
• Last Updated: January 11, 2017

Record last verified: 2017-01

Locations

FR (1)