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Two interventions were combined as one
| The first 150 words of the full text of this article appear below. |
EDITOR
Lattimer et al report a randomised controlled trial to show the
safety and effectiveness of nurse telephone consultations in out of
hours primary care.1 I accept that the results showed a
reduced workload for general practitioners from the nurse intervention, probably at an increased cost. For methodological reasons, however, I
am less certain whether the results show safety.
Lattimer et al report that during intervention periods, 49.8% of the
calls could be managed by the nurse alone without referral to a doctor.
This implies that 50.2% of the calls were assessed twice: once by an
experienced and specially trained nurse using a systematic assessment
with the aid of decision support software and then by the general
practitioner in attendance. I would expect that the improved diagnosis
and management in this subgroup would lead to much better clinical
outcomes than in the control group, which had only one assessment