| Project Objectives / Summary:
In the UK, the "What should I do? Do I Go to the Doctor?" booklet has been successful in educating patients about the selfcare of minor illnesses and when it would be appropriate to use primary care and after hours services. The project's aims were to measure the benefits and acceptability of the UK booklet by Australian GPs and patients in two general practice casualty or community accident and emergency departments providing after hours primary care services. These departments are staffed by GPs from the local Division of General Practice. In addition, this project aimed to evaluate the content and appropriateness of the selfcare information for Australian patients attending the after hours service.
Project Collaboration:
- RACGP
- Health Connect Telephone Triage Service
- Balmain General Practice Casualty
- Central Sydney Area Health Service
Project Outcomes:
Review contents and make necessary amendments to the UK booklet "What should I do? Do I go to the Doctor?" The booklet was reviewed and amendments made by four GPs from diverse backgrounds. The amendments were also reviewed by the St Johns Ambulance Training and Education Department to ensure that the content was not in conflict with any of its training and resource materials.
Booklet trialed in the After Hours Telephone Triage Service Health Connect (Central Sydney Area Health Service) rather than the Canterbury Emergency Department.
Dr Clare Cuppitt (a part time GP from Forbes and Eugowra, NSW) is trialling the distribution of 100 copies of the Australian booklet within her rural practices as an attempt to reduce her patient load but still provide healthcare management in a rural community with an acute shortage of GPs. Availability of the booklet spread by word of mouth with all copies being distributed much earlier than anticipated. Evaluation of this component of the trial is less formal than in the others.
Recommendations:
There is a cost associated in getting the booklet out to the consumer. If GPs are to use the booklet, then the best method of incorporating the booklet into their practice needs to be explored.
Lessons / Assessment:
There appears to be a direct relationship between the mode of access (face to face contact - GPC versus telephone contact - Health Connect) and the subsequent opinion and use of the booklet. Those that received the book in the mail were more likely to read the booklet, rate the booklet as "very useful", and were more likely to say the booklet changed the way they dealt with their illness.
Those respondents receiving the booklet after phone contact were less likely to report that they received instructions about the study.
Respondents generally found the booklet useful. Of particular note are the responses by respondents with children, who found it particularly useful and a valuable resource to have on hand.
Respondents from both locations (GPC & Health Connect) did not differ in their responses pertaining to how the booklet would effect their future management of other medical problems. Although the highest percentage group said the booklet had changed their management, this was not quantifiable due to the question structure. The second highest percentage group said they managed the condition themselves. Only 4.7% went to the GP with a new or different condition as a result of using the booklet. The results suggest that the use of patient self care information does impact on the decision that individuals make in regard to their health care and that these tend to create a move towards self management rather than increasing health care seeking behaviour from existing health services.
In summary, a useful project with useful results that can be fed into wider policy consideration of issues such as after hours care and use by patients of hospital emergency departments rather than general practice. It needs to be recognised that this approach is just one mechanism for bringing about attitudinal change by consumers. It does not guarantee behaviour change.
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