TELEPHONE CONSULTATIONS
Telephone consultations in primary care: scoping review
Background
Despite the widespread use of telephones in everyday life, the use of telephone consultations in primary care has been somewhat limited. Evidence to support the use of telephones in areas such as consultation, triage, support and treatment has often been lacking. The value of telephone consultations has been seen largely in terms of whether it saves doctors’ time, rather than whether it improves access and care. Case studies of telephone consultation have suggested that its potential is far wider than this, and that it offers benefits to patients as well as to doctors.
This scoping review described the extent and nature of the existing literature relating to the benefits, harms and barriers to telephone consultations in primary care, with the aim of assessing the potential for a systematic review of the topic area and to identify areas requiring further primary research.Findings
There appears to be a lack of good quality primary research investigating the effectiveness of telephone consultations in primary care, and the majority of evidence that does exist is observational or qualitative research.
There is a need for good quality RCTs and controlled trials with the main objective of assessing the effectiveness of telephone consultation. Although some systematic reviews do exist in the area of telephone consultations, most do not have this as their primary objective.
There appears to be very limited relevant literature available in relation to the following areas of potential interest: the benefits of previous personal contact or access to medical records; improving access of disadvantaged groups; obstacles to increase telephone use; and more appropriate use of the route by patients and doctors. There is only slightly more evidence available regarding the most effective arrangements for telephone consultations; the skills and training required; and the best person to carry out telephone consultations, and a minority of these studies are of more rigorous design.
The largest and strongest primary evidence base exists in the area of the benefits and harms of telephone consultations to the patient and health professional, and it is this area that a future systematic review investigating the effectiveness of telephone consultations might be considered.
Conducted by: Anita Kainth1, Catriona McDaid1, Julie Glanville1, Kath Wright1, Peter Toon2, Carol Forbes11. Centre for Reviews and Dissemination; 2. Department of Primary Care and Population Sciences, University of London
Publications
Centre for Reviews and Dissemination. Telephone consultations in primary care: a scoping review. A report for the funders. York: University of York; 2003Funding
The DH Policy Research Programme funded designated review capacity to enable CRD to provide a timely response to PRP requests for reviews. This review was undertaken as part of that funding.