title: Patient use and compliance with medical advice delivered by a web-based triage system in primary care.
abstract: We studied a web-based triage system which was accessible to the general public in the Netherlands. In a retrospective analysis we investigated the type of complaints that were submitted and the kind of advice provided. Over a period of 15 months, 13,133 different people began using the web-based triage system and 3812 patients went right through the triage process to the end. The most frequent complaints were common cold symptoms, such as cough and a sore throat (22%), itch problems (13%), urinary complaints (12%), diarrhoea (10%), headache (8%) and lower back pain (8%). Most commonly, the system generated the advice to contact a doctor (85%) and in 15% of the cases the system provided fully automated, problem-tailored, self-care advice. A total of 192 patients participated in a prospective study and completed an online survey immediately after the delivery of advice. A follow-up questionnaire on actual compliance was completed by 35 patients. Among these, 20 (57%) had actually complied with the advice provided by the system. A regression analysis revealed that intention to comply was strongly related to actual compliance. In turn, intention to comply was strongly related to attitude towards the advice (P < 0.001). Web-based triage can contribute to a more efficient primary care system, because it facilitates the gatekeeper function.
authors.affiliation: Department of Psychology and Communication of Health and Risk, Faculty of Behavioural Sciences, University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands. n.nijland@utwente.nl
authors.forename: Nicol
authors.initials: N
authors.lastname: Nijland
authors.forename: Karlijn
authors.initials: K
authors.lastname: Cranen
authors.forename: Henk
authors.initials: H
authors.lastname: Boer
authors.forename: Julia E W C
authors.initials: JE
authors.lastname: van Gemert-Pijnen
authors.forename: Erwin R
authors.initials: ER
authors.lastname: Seydel
mesh_terms: D000293:Adolescent; D000328:Adult; D003658:Decision Making, Computer-Assisted; D005260:Female; D020793:Gatekeeping; D006801:Humans; D020407:Internet; D008297:Male; D009426:Netherlands; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011320:Primary Health Care; D019114:Remote Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012648:Self Care; D012720:Severity of Illness Index; D014218:Triage; D055815:Young Adult