This study adds to the message of the main trial, that telephone triage, whether undertaken by a doctor or a nurse, appears not to offer added efficiency in terms of resource use than usual care.
Telephone triage is a commonly used approach for handling requests for same-day GP appointments. Through the recent ESTEEM trial, researchers have been measuring the impact on primary care workload of introducing GP-led or nurse-led telephone triage compared with continuing usual care.
Led by Dr Tim Holt from Oxford University’s Nuffield Department of Primary Care Health Sciences, primary care researchers used data from the trial to measure the impact on clinician-patient contact time on the day of the request. Their overall finding suggests no overall reduction with telephone triage, although nurse-led triage did reduce GP-patient contact time.
The researchers looked at data from 16,711 initial clinician-patient contacts, plus 1290 GP and 176 nurse face-to-face consultations. The mean duration of initial contacts was 4 minutes for GP triage and 6.6 minutes for nurse triage compared with 9.5 minutes for usual care. The estimated duration of overall contact was 10.3 minutes for GP triage, 14.8 minutes for nurse triage, and 9.6 minutes for usual care. In nurse triage, more than half of the duration of clinician contact time was with a GP (7.7 minutes), which was less than the 9 minutes of GP time used in a GP triage.
Writing in the BJGP, the authors say “This study adds to the message of the main trial, that telephone triage, whether undertaken by a doctor or a nurse, appears not to offer added efficiency in terms of resource use than usual care. However, individual practices may wish to interpret the findings in the context of the available skill mix of clinicians.”
The BJGP list of most read research articles is based on full text downloads from bjgp.org in 2016. The most read paper from 2016 is a study from Julius Health Care Centers in Utrecht, the Netherlands which finds that overdiagnosis of childhood asthma is common in primary care in the Netherlands, leading to unnecessary treatment, disease burden, and impact on quality of life, and shows the need to follow the correct diagnostic strategy when diagnosing asthma in children.