Interventions to increase or decrease the length of primary care physicians' consultation.

Area of Science:

• General Practice
• Health Services Research

Background:

• Observational studies suggest differences in primary care physician consultation processes and outcomes based on varying consultation lengths.
• These observed differences may be influenced by self-selection bias.
• This review is the first update of an original assessment.

Purpose of the Study:

• To evaluate the impact of interventions designed to modify the duration of primary care physician consultations.

Main Methods:

• Searched multiple electronic databases (CENTRAL, MEDLINE, EMBASE, ClinicalTrials.gov, WHO ICTRP) up to January 4, 2016.
• Included randomized controlled trials and non-randomized controlled trials of interventions altering consultation length.
• Data extraction and risk of bias assessment were performed independently by two reviewers; a narrative summary was provided due to study heterogeneity, with GRADE approach used for evidence certainty.

Main Results:

• Five UK-based studies were included, all testing short-term changes in allocated patient consultation time.
• Overall confidence in the results was very low, with most studies exhibiting high risk of bias (e.g., non-random allocation, missing data, small sample sizes).
• Evidence is insufficient to determine if altering appointment length affects consultation duration, referrals, investigations, prescriptions, or patient satisfaction; resource utilization was not reported.

Conclusions:

• Insufficient evidence exists to support or reject policies aimed at altering primary care physician consultation lengths.
• Findings may be revised with future high-quality trials.
• Further research focusing on health outcomes and cost-effectiveness is recommended.