Comparison of the accuracy of patients' recall of the content of telephone and face-to-face consultations: an exploratory study

Abstract

BACKGROUND To comply with an action plan patients need to recall information accurately. Little is known about how well patients recall consultations, particularly telephone consultations increasingly used to triage acute problems. PURPOSE OF STUDY This was an exploratory study to measure how accurately patients recall the content of face-to-face and telephone consultations and what factors may be associated with accurate recall. STUDY DESIGN In Scotland in 2008, the advice (diagnoses; management plan(s); and safety-netting arrangements) given in audio recorded face-to-face and telephone consultations was compared with the advice recalled by patients at interview approximately 13&emsp14;days later. Patients also performed a memory test. Interactions were sought between accurate recall, consultation type, and factors postulated to influence recall. RESULTS Ten general practitioners (GPs) and 175 patients participated; 144 (82%) patients were interviewed. Patients recalled most important components of telephone and face-to-face consultations equally accurately or with only minor errors. Overall, patients presenting multiple problems (p<0.001), with brain injury (p<0.01) or low memory score (p<0.01) had reduced recall. GPs rarely used strategies to improve recall; however, these were not associated with improved recall. CONCLUSIONS Contrary to previous hospital based research, patients tended to remember important components of both face-to-face and telephone consultations-perhaps reflecting the familiar, less anxiety provoking environment of primary care. The unsuccessful use of strategies to improve recall may reflect selective use in cognitively impaired patients. Clinicians should compensate for situations where recall is poorer such as patients presenting multiple problems or with brain injury. Patients might be advised to restrict the number of problems they present in any one consultation.

The acceptability to patients of video-consulting in general practice: semi-structured interviews in three diverse general practices.

“…Likewise, it is possible that differences between age groups may reflect access to the appropriate technology and training, rather than any bias against it. The practices sampled also already used telephone consulting extensively, which may have strengthened patient predisposition towards video consulting 12 , 19. In addition there was missing data, mainly due to declined postcodes (11%) and ages (8%), but we feel that this is unlikely to affect our conclusions.…”

“…Previous research into alternative technologies has mainly focused on telephone consulting6 , 10 and has contributed to progress in understanding its application12 and impact on the doctor–patient relationship,13 – 15 particularly in primary12 , 15 and out-of-hours care 16. The possible utility of email and short message service has also been investigated 17 , 18.…”

What factors affect patients' recall of general practitioners' advice?

“…In their recent study, McKinstry et al [25] sought interactions between accurate recall, consultation type and factors postulated to influence recall, and reported poorer recall in patients presenting multiple problems, with brain injury or a low memory score. Since our study excluded patients with multiple problems, and the findings reflect single health problem situations, recalling information when dealing with more health complaints in patients is still to be studied.…”

“…Since our study excluded patients with multiple problems, and the findings reflect single health problem situations, recalling information when dealing with more health complaints in patients is still to be studied. When four instructions were given to the patients, the GP could be almost certain that patient would not recall one or two of them (Table 1); on the other hand, patients might be advised to restrict the number of problems they present in any one consultation [25]. …”

Geographical barriers to education law advice: access, communications and public legal services in England and Wales

“…However, a recently completed controlled trial comparing face‐to‐face and telephone consultations found comparable levels of advice recall amongst patients (McKinstry et al . ).…”