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| ID | Type | Description | Link |
|---|---|---|---|
| 2013-AO1722-43 | Other Identifier | IDRCB |
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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.
This is a prospective, open label, cluster randomized trial of 2 880 expected patients who calling a French emergency medical service Dial 15 for fever or gastroenteritis symptoms during out-of-hours periods. All calls will be taken by a general practitioner (GP). Out-of-hours period is defined as 8 PM to 8 AM on weekdays, 1 PM to 8PM on Saturdays in addition to Sundays and holidays.To be exhaustive, we will enrol patients during one year.
In the experimental arm, the GP will implement a protocol of care to each patient call. The protocol includes 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 GP during working hours.
In the non-interventional arm, the GP will decide the need of telephone advice with or without drug prescription, home visit by a doctor, emergency department services with or without EMS system.
We will recall every patient at 15+/-4 days.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 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. |
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| 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. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 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 |
| Measure | Description | Time Frame |
|---|---|---|
| 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 |
| Measure | Description | Time Frame |
|---|---|---|
| Cost effectiveness | Cost effectiveness based on the economic analysis in each arm (sick leaves, hospitalization, EMS or firemen use...) | at 15 days |
| Care Mobile Units use | at 15 days |
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Inclusion Criteria:
Disease:
Onset of symptoms for less than 72 hours
Age ≥ 18 years caller
Patient age ≥ 1 year
Affiliation to the French National Health Service
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Frédéric ADNET, MD, PhD | Assistance Publique - Hôpitaux de Paris | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| SAMU 93 - EA 3409 - Faculté de Médecine de Bobigny - Université Paris 13 | Bobigny | Île-de-France Region | 93009 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34251142 | Derived | 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. | |
| 27659897 |
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| 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. |
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| Emergency Medical Service use | at 15 days |
| Firemen use | Number of fireman use | at 15 days |
| Recall at dispatching centre | at 15 days |
| Number and length of sick leave | at 15 days |
| All causes mortality | at 15 days |
| Morbidity | at 15 days |
| Patient satisfaction | Patient satisfaction evaluated by a 14 items questionnaire ans a numeric scale from 0 to 10 | at 15 days |
| Patient adhesion | Percentage of patient's adhesion to the advice and/or drug prescriptions | at 15 days |
| Clinical outcome | Percentage of relieved patients | at 15 days |
| Number of stay in intensive care unit | at 15 days |
| Number of hospitalisation | at 15 days |
| Number of patients seen repeatedly | at 15 days |
| 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. |