Evidence map›Paper›PMID 35395840›Full record

Trial reportBMC health services research2022

Non-compliance with a nurse's advice to visit the primary care provider: an exploratory secondary analysis of the TRIAGE-trial.

Ines Homburg, Stefan Morreel, Veronique Verhoeven, Koenraad G Monsieurs, Jasmine Meysman, Hilde Philips, Diana De Graeve

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03793972 (Triaging and Referring in Adjacent General and Emergency Departments), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03793972 nacompletednot on this map

Triaging and Referring in Adjacent General and Emergency Departments (the TRIAGE-trial): a Cluster Randomised Controlled Trial

TypeinterventionalSponsorUniversiteit AntwerpenRan2019 to 2019Enrolled8,158ConditionsTriageArmsTriage with referral to primary care, Usual care
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Article
  4. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ines HomburgDepartment of Economics, University of Antwerp, Antwerp, Belgium. ines.homburg@student.uantwerpen.be.
Stefan MorreelDepartment of Family and Population Health, University of Antwerp, Antwerp, Belgium.
Veronique VerhoevenDepartment of Family and Population Health, University of Antwerp, Antwerp, Belgium.
Koenraad G MonsieursDepartment ASTARC, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.
Jasmine MeysmanDepartment of Economics, University of Antwerp, Antwerp, Belgium.
Hilde PhilipsDepartment of Family and Population Health, University of Antwerp, Antwerp, Belgium.
Diana De GraeveDepartment of Economics, University of Antwerp, Antwerp, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDuring the cluster randomised TRIAGE-trial, a nurse advised 13% of low-risk patients presenting at an emergency department in Belgium to visit the adjacent general practitioner cooperative. Patients had the right to refuse this advice. This exploratory study examines the characteristics of refusers by uncovering the determinants of non-compliance and its impact on costs, as charged on the patient's invoice.

methodsBivariate analyses with logistic regressions and T-tests were used to test the differences in patient characteristics, patient status, timing characteristics, and costs between refusers and non-refusers. A chi-square automatic interaction detection analysis was used to find the predictors of non-compliance.

results23.50% of the patients refused the advice to visit the general practitioner cooperative. This proportion was mainly influenced by the nurse on duty (non-compliance rates per nurse ranging from 2.9% to 52.8%) and the patients' socio-economic status (receiving increased reimbursement versus not OR 1.37, 95%CI: 0.96 to 1.95). Additionally, non-compliance was associated (at the 0.10 significance level) with being male, not living nearby and certain reasons for encounter. Fewer patients refused when the nurse perceived crowding level as quiet relative to normal, and more patients refused during the evening. The mean cost was significantly higher for patients who refused, which was a result of more extensive examination and higher out-of-pocket expenses at the ED.

conclusionsThe nurse providing the advice to visit the general practitioner cooperative has a central role in the likelihood of patients' refusal. Interventions to reduce non-compliance should aim at improving nurse-patient communication. Special attention may be required when managing patients with a lower socio-economic status. The overall mean cost was higher for refusers, illustrating the importance of compliance.

trial registrationThe trial was registered on registration number NCT03793972 on 04/01/2019.

Indexed as

Emergency NursingPatient ComplianceReferral and ConsultationBelgiumEmergency Service, HospitalFemaleGeneral PractitionersHumansMalePrimary Health CareAfter-hours careCostsEmergency departmentGeneral practitioners cooperativeNon-compliancePrimary careTriage

Identifiers

PMID35395840
PMCPMC8994354

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.