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Systematic Reviews

The effects of telephone consultation and triage on healthcare use and patient satisfaction: a systematic review

Frances Bunn, Geraldine Byrne and Sally Kendall
British Journal of General Practice 2005; 55 (521): 956-961.
Frances Bunn
Roles: Research Fellow in Evidence-Based Practice
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Geraldine Byrne
Roles: Principal Lecturer
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Sally Kendall
Roles: Professor of Nursing
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Abstract

Background In recent years there has been a growth in the use of the telephone consultation for healthcare problems. This has developed, in part, as a response to increased demand for GP and accident and emergency department care.

Aim To assess the effects of telephone consultation and triage on safety, service use, and patient satisfaction.

Design of study We looked at randomised controlled trials, controlled studies, controlled before/after studies, and interrupted time series of telephone consultation or triage in a general healthcare setting.

Setting All healthcare settings were included but the majority of studies were in primary care.

Method We searched the Cochrane Central Register of Controlled Trials, EPOC specialised register, PubMed, EMBASE, CINAHL, SIGLE, and the National Research Register and checked reference lists of identified studies and review articles. Two reviewers independently screened studies for inclusion, extracted data, and assessed study quality.

Results Nine studies met our inclusion criteria: five randomised controlled trials; one controlled trial; and three interrupted time series. Six studies compared telephone consultation with normal care; four by a doctor, one by a nurse, and one by a clinic clerk. Three of five studies found a significant decrease in visits to GPs but two found an increase in return consultations. In general at least 50% (range = 25.5–72.2%) of calls were handled by telephone consultation alone. Of seven studies reporting accident and emergency department visits, six showed no difference between the groups and one — of nurse telephone consultation — found an increase. Two studies reported deaths and found no difference between nurse telephone consultation and normal care.

Conclusions Although telephone consultation appears to have the potential to reduce GP workload, questions remain about its effect on service use. Further rigorous evaluation is needed with emphasis on service use, safety, cost, and patient satisfaction.

  • consultation
  • hotlines
  • review, systematic
  • telephone
  • triage
  • Received November 10, 2004.
  • Revision received February 4, 2005.
  • Accepted April 22, 2005.
  • © British Journal of General Practice, 2005.
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British Journal of General Practice: 55 (521)
British Journal of General Practice
Vol. 55, Issue 521
December 2005
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The effects of telephone consultation and triage on healthcare use and patient satisfaction: a systematic review
Frances Bunn, Geraldine Byrne, Sally Kendall
British Journal of General Practice 2005; 55 (521): 956-961.

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The effects of telephone consultation and triage on healthcare use and patient satisfaction: a systematic review
Frances Bunn, Geraldine Byrne, Sally Kendall
British Journal of General Practice 2005; 55 (521): 956-961.
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Keywords

  • consultation
  • hotlines
  • review, systematic
  • telephone
  • triage

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Print ISSN: 0960-1643
Online ISSN: 1478-5242