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Trial registered on ANZCTR
Registration number
ACTRN12617001536358
Ethics application status
Approved
Date submitted
28/07/2017
Date registered
6/11/2017
Date last updated
28/09/2022
Date data sharing statement initially provided
28/09/2022
Date results provided
28/09/2022
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effetiveness of an new model of shared telephonic patient referral between primary health care and hospital health care.
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Scientific title
Effectiveness of a new model of telephonic patient referral from primary health care to Internal Medicine consultation to reduce the waiting list period.
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Secondary ID [1]
292550
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NONE
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Universal Trial Number (UTN)
U1111-1199-9475
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Trial acronym
DETELCOM
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
INTERNAL MEDICINE DISEASES
304207
0
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Condition category
Condition code
Cardiovascular
303544
303544
0
0
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Other cardiovascular diseases
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Inflammatory and Immune System
303545
303545
0
0
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Other inflammatory or immune system disorders
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Public Health
303653
303653
0
0
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Health service research
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients referrals were carreid out via telephone consultation so that the General Practitoners were able to consult directly the Internal Medicine doctors by telephone in order to obtain an early diagnosis. The time to access to the General Practitioner for the first consultation was from 1 to 3 days. During this first telephone consult between the General Practitioner and the Internal Medicine specialist, they both reached an agreement concerning the treatment, and the complementary tests and future check-up were scheduled. The timing for obtaining the results of the complementary tests was 17 days.
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Intervention code [1]
298747
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Diagnosis / Prognosis
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Comparator / control treatment
Control groups patients were referrred to Internal Medicine consultation by the traditional way, which involves a waiting list of 51 days and having to be moved several times to the nearest hospital with Internal Medicine consultation (Riotinto Hospital), which is about one hour from the participants´ locations.
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Control group
Active
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Outcomes
Primary outcome [1]
302912
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Change in waiting list time (number of days) from primary health care to internal consultation, assessed by review of medical records available at "Diraya" (institutional medical record system)
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Assessment method [1]
302912
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Timepoint [1]
302912
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Baseline (first visit to the General Practitioner) and first visit to Internal Medicine Consultation
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Secondary outcome [1]
337689
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Patient´s acceptance of this new model of referral, which was assessed asking them about their reasons to abandon the trial.
Only 9 patients refused to participate in the trial because they preferred the traditional referral way.
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Assessment method [1]
337689
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Timepoint [1]
337689
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Baseline (first visit to the General Practitioner consultation)
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Secondary outcome [2]
337690
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Doctors´ acceptance of this new model of referral, which was assessed asking them about their reasons to abandon the trial.
Only 8 doctors refused to participate in the trial because they thought this way would involve more dedication to each patient.
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Assessment method [2]
337690
0
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Timepoint [2]
337690
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Baseline (first visit to General Practitioner consultation)
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Eligibility
Key inclusion criteria
Every patient who needed to be referred to Internal Medicine Hospital Consultation according to the Geeral Practitioners´decision.
General Practitioners from the north area of Huelva (Spain) who agreed to participate in the trial.
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Minimum age
18
Years
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Maximum age
85
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Whenever the General Practitioner considered that a patient would not get significant benefit from the telephone referral.
Patients who refused to participate in the study
General Practitioners who refused to participate in the trial.
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Stratified randomisation: General Practitioners were randomised
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
1.- DESCRIPTIVE ANALYSIS
2.- KRUSKALL-WALLIS TEST
3.- MANN-WHITNEY TEST (p= 0.01 CI 99%)
4.-HODGES-LEHMAN TEST FOR INDEPENDENT SAMPLES
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/03/2016
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Date of last participant enrolment
Anticipated
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Actual
23/12/2016
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Date of last data collection
Anticipated
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Actual
12/01/2017
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Sample size
Target
150
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Accrual to date
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Final
154
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Recruitment outside Australia
Country [1]
9111
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Spain
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State/province [1]
9111
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SEVILLE
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Funding & Sponsors
Funding source category [1]
297126
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Self funded/Unfunded
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Name [1]
297126
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NOT APPLICABLE
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Address [1]
297126
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NOT APPICABLE
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Country [1]
297126
0
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Primary sponsor type
Individual
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Name
LUIS MIGUEL AZOGIL LÓPEZ
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Address
Centro de Salud de Valverde del Camino
Plaza de la Constitución, s/n
21600 - Huelva. Spain
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Country
Spain
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Secondary sponsor category [1]
296138
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Individual
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Name [1]
296138
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ESTHER MARÍA MEDRANO SANCHEZ
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Address [1]
296138
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University of Seville. Faculty of Nursing, Physiotherapy and Podiatry.
Calle Avenzoar, 6
41009 SEVILLE
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Country [1]
296138
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Spain
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Secondary sponsor category [2]
296139
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Individual
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Name [2]
296139
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MARÍA DEL VALLE CORONADO VÁZQUEZ
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Address [2]
296139
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Departamento de Sanidad. Gobierno de Aragón
Edificio Vía Universitas
Vía Universitas, 36 - 8ª planta
50071 Zaragoza (Spain)
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Country [2]
296139
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Spain
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298300
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Fundación Andaluza Beturia para la Investigación en Salud (F.A.B.I.S.)
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Ethics committee address [1]
298300
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4ª Planta Hospital Juan Ramón Jiménez Ronda Norte s/n 21005. Huelva T: 959.016.760 - F: 959.016.804/5 http://www.fabis.org
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Ethics committee country [1]
298300
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Spain
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Date submitted for ethics approval [1]
298300
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10/04/2015
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Approval date [1]
298300
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21/09/2015
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Ethics approval number [1]
298300
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Summary
Brief summary
Aim: The purpose of this study is to find out whetheror not telephone referral from Primary Health Care to Internal Medicine Consult manages to reduce waiting days as compared to traditional referral. This study also aims to know how acceptable is the telephone referral to general practitioners and their patients. Design: No blind randomized controlled clinical trial. Setting Northern Huelva Health District. Participant 154 patients. Interventions Patients referrals from intervention clinicians were sent via telephone consultation, whereas patients referrals from control clinicians were sent by the traditional method for a face-to-face consultation, Measurements: Number of days from referral request to Internal Medicine Consult; Number of telephone and traditional referrals; Number of doctors and patients denied; Denial reasons. Results: A statistically significant difference was found between groups, with an average of 27 (21-34) days. Among General Practitioners, 8 of the first 58 total doctors after randomization and, subsequently, 6 of the 20 doctors of the test group refused to engage in the trial because they considered “excessive time and effort consuming”. 50 % of patients referred by the 14 General Practitioners finally randomized to the intervention group were denied referral by telephone due to patient’s complexity. Conclusions: Telephone referral significantly reduces waiting days for internal medicine consult. This type of referral did not mean an “excessive time and effort consuming” to General Practitioners and was not all that beneficial to complex patients.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Mr LUIS MIGUEL AZOGIL LÓPEZ
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Address
76638
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BALTASAR DE ALCAZAR ST, Nº 4, 1ºC
41008 SEVILLE
AFFILIATION: ANDALUSIAN HEALTH CARE PUBLIC SYSTEM (SISTEMA ANDALUZ DE SALUD)
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Country
76638
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Spain
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Phone
76638
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+ 34 646 500 778
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Fax
76638
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+34 954 486 527
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Email
76638
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[email protected]
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Contact person for public queries
Name
76639
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ESTHER MARÍA MEDRANO SANCHEZ
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Address
76639
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DIEGO ANGULO IÑIGUEZ ST. Nº 6, BLOCK 3, 1º C
41018 SEVILLE
AFFILIATION: UNIVERSITY OF SEVILLE
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Country
76639
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Spain
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Phone
76639
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+34 609 076 282
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Fax
76639
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+34 954 486 527
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Email
76639
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[email protected]
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Contact person for scientific queries
Name
76640
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ESTHER MARIA MEDRANO SANCHEZ
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Address
76640
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DIEGO ANGULO IÑIGUEZ ST. Nº 6, BLOCK 3, 1º C
41018 SEVILLE
AFFILIATION: UNIVERSITY OF SEVILLE
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Country
76640
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Spain
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Phone
76640
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+34 609 076 282
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Fax
76640
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+ 34 954 486 527
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Email
76640
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
We are not allowed to share individual participant data because of the Spanish Law of personal data protection and digital rights guarantee (https://www.boe.es/eli/es/lo/2018/12/05/3/con).
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
DETELPROG study. Effectiveness of a new model of scheduled telephone referral from primary care to internal medicine. a randomised controlled study.
2019
https://dx.doi.org/10.3390/jcm8050688
N.B. These documents automatically identified may not have been verified by the study sponsor.
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