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Primary Care

Randomised controlled trial of self management leaflets and booklets for minor illness provided by post

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7296.1214 (Published 19 May 2001) Cite this as: BMJ 2001;322:1214
  1. Paul Little, MRC clinician scientist (psl3{at}soton.ac.uk)a,
  2. Jane Somerville, research assistanta,
  3. Ian Williamson, senior lecturera,
  4. Greg Warner, general practitionerb,
  5. Michael Moore, general practitionerc,
  6. Rose Wiles, senior research fellowd,
  7. Steve George, readere,
  8. Ann Smith, primary care advisorf,
  9. Robert Peveler, professorg
  1. a Primary Medical Care Group, Aldermoor Health Centre, Southampton SO16 5ST
  2. b Nightingale Surgery, Greatwell Drive, Romsey
  3. c Three Swans Surgery, Rollestone Street, Salisbury
  4. d Health Research Unit, School of Occupational Therapy and Physiotherapy, Southampton University
  5. e Health Care Research Unit, Wessex Institute of Health Research and Development, Community Clinical Sciences, Health Medicine and Biological Sciences Division, Southampton University
  6. f Southampton and South West Hants Health Commission, Southampton
  7. g Mental Health Group, Department of Psychiatry, Community Clinical Sciences, Health Medicine and Biological Sciences Division, Southampton University
  1. Correspondence to: P Little
  • Accepted 3 February 2001

Abstract

Objective: To assess the effectiveness of providing information by post about managing minor illnesses.

Design: Randomised controlled trial.

Setting: Six general practices.

Participants: Random sample of 4002 patients from the practice registers.

Intervention: Patients were randomised to receive one of three kinds of leaflet or booklet endorsed by their general practitioner: control (surgery access times), booklet, or summary card.

Main outcome measures: Attendance with the 42 minor illnesses listed in the booklet. Perceived usefulness of leaflets or booklets, confidence in managing illness, and willingness to wait before seeing the doctor.

Results: 238 (6%) patients did not receive the intervention as allocated. Of the remaining 3764 patients, 2965 (79%) had notes available for review after one year. Compared with the control group, fewer patients attended commonly with the minor illnesses in the booklet group (≥2 consultations a year: odds ratio 0.81, 95% confidence interval 0.67 to 0.99) and the summary card group (0.83; 0.72 to 0.96). Among patients who had attended with respiratory tract infections in the past year there was a reduction in those attending in the booklet group (0.81; 0.62 to 1.07) and summary card group (0.67; 0.51 to 0.89) compared with the control group. The incidence of contacts with minor illness fell slightly compared with the previous year in the booklet (incidence ratio 0.97; 0.84 to 1.13) and summary card groups (0.93; 0.80 to 1.07). More patients in the intervention groups felt greater confidence in managing illness (booklet 32%, card 34%, control 12%, P<0.001), but there was no difference in willingness to wait score (all groups mean=32, P=0.67).

Conclusion: Most patients find information about minor illness provided by post useful, and it helps their confidence in managing illness. Information may reduce the number attending commonly with minor illness, but the effect on overall contacts is likely to be modest. These data suggest that posting detailed information booklets about minor illness to the general population would have a limited effect.

What is already known on this topic

What is already known on this topic Increasing attendance for minor illness in primary care is a threat to consultation time and quality of care

Few recent studies have examined the effect of providing patients with information on self management of minor illness

What this study adds

What this study adds Most patients find information about minor illness provided by post useful, and it helps their confidence in managing illness

Information booklets and leaflets reduced the number attending frequently with minor illness, but the effect on overall contacts was not significant Information booklets on minor illness provided by post may have a limited role in the NHS

Footnotes

  • Funding This work was funded by a NHS Regional Research and Development Grant. PL is funded by the Medical Research Council (except for his clinical practice at Nightingale surgery).

  • Competing interests None declared.

  • Accepted 3 February 2001
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