The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
Community Nursing and Public Health, Centre for Health Services Studies, University of Kent, Canterbury, United Kingdom.
Telemed J E Health. 2024 Feb;30(2):364-380. doi: 10.1089/tmj.2023.0002. Epub 2023 Aug 25.
Telephone consultation (TC) is widely used for its easy access and convenience. This review aimed to assess the effects of TC including triage on safety, service use, patient satisfaction, and health professionals' workload to inform directions for future health service practice. CENTRAL, MEDLINE, Embase, CINAHL, ProQuest Dissertation & Theses (Health & Medicine), ClinincalTrials.gov, and International Clinical Trial Registry Platform were searched on April 7, 2022. The included were randomized controlled trials that compared TC with standard (face-to-face [F2F]) management or that by another group of call advisers. Cochrane methods were used to select eligible studies, assess the risk of bias, estimate summary effect measure, and grade evidence certainty. Meta-analysis was performed on important outcomes with moderate- or high-quality evidence. Eight studies were included involving 40,002 participants. TC could increase call resolution-proportion of callers' concerns being addressed by telephone advice alone (two studies; high certainty) and reduce F2F contacts with doctors for the first consultation (two studies, moderate certainty) compared with standard management or TC by doctors. None of included studies reported increases in adverse events, including all-cause mortality, acute and emergency department visit, and hospitalization. There was inadequate evidence regarding the effects of TC on patient satisfaction and length of consultation. The findings support the benefits of TC on improving call resolution and reducing F2F contacts with doctors on the day of first management for regular day service; and TC by nurses can provide better effects than that by doctors for out-of-hours service.
电话咨询（TC）因其易于获取和便捷而被广泛应用。本综述旨在评估 TC（包括分诊）在安全性、服务使用、患者满意度和卫生专业人员工作量方面的效果，为未来的卫生服务实践提供方向。2022 年 4 月 7 日，对 CENTRAL、MEDLINE、Embase、CINAHL、ProQuest Dissertation & Theses（健康与医学）、ClinincalTrials.gov 和国际临床试验注册平台进行了检索。纳入的研究为随机对照试验，比较了 TC 与标准（面对面[F2F]）管理或另一组呼叫顾问的管理。使用 Cochrane 方法选择合格的研究、评估偏倚风险、估计汇总效应测量值和分级证据确定性。对具有中等到高质量证据的重要结局进行了荟萃分析。纳入的八项研究共涉及 40002 名参与者。与标准管理或医生进行的 TC 相比，TC 可以增加电话咨询的解决率——仅通过电话咨询解决来电者关注问题的比例（两项研究；高确定性）和减少首次咨询时与医生的 F2F 接触（两项研究，中等确定性）。纳入的研究均未报告不良事件增加，包括全因死亡率、急性和急诊就诊以及住院治疗。关于 TC 对患者满意度和咨询时间长短的影响，证据不足。研究结果支持 TC 改善电话咨询解决率和减少首次管理当天与医生的 F2F 接触的益处；在非工作时间，护士进行 TC 比医生进行 TC 效果更好。
