Follow-through after calling a nurse telephone advice line: a population-based study

Fam Pract. 2010 Jun;27(3):271-8. doi: 10.1093/fampra/cmq003. Epub 2010 Mar 9.


Background: Nurse telephone advice (NTA) lines, a major initiative in primary health care reform, provide symptom triage and health information. Compliance studies utilizing database analysis are frequently limited to a defined population, such as children or Emergency Department (ED) users.

Objectives: To explore caller characteristics associated with following NTA advice to go to the ED, see a health care professional or self-care for Calgary, Canada (population 1 million).

Methods: NTA data were linked with utilization data to assess ED and physician visits following a call. Four nurse advice categories were defined: go to ED, health care provider in 24 hours, health care provider in 72 hours if symptoms persist and self-care. Follow-through was defined based on health care utilization within specified time periods following the call. Logistic regression identified characteristics associated with follow-through of NTA nurse advice; characteristics included age, sex, neighbourhood income, health status, time of call and type of care protocol.

Results: Follow-through was highest for self-care advice (83.7%), followed by ED advice (52.3%) and then 24-hour advice (43.2%). Lower follow-through on ED or 24-hour advice was associated with age <4 years, and having lower income, and the opposite was true for self-care advice. Patients with a cardiac complaint had the highest odds of following ED advice. Patients with a gastrointestinal or obstetrics/gynaecology/genitourinary complaint were less likely to follow 24-hour advice. Patients with fever were less likely to follow self-care advice.

Conclusions: Understanding characteristics associated with lower follow-through may help the NTA service to refine its approaches to clients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Alberta
  • Child
  • Child, Preschool
  • Continuity of Patient Care*
  • Databases, Factual
  • Emergency Medicine
  • Family Practice
  • Female
  • Hotlines*
  • Humans
  • Male
  • Middle Aged
  • Nurse-Patient Relations*
  • Remote Consultation*
  • Young Adult