The Effectiveness and Cost-effectiveness of Medical Advice Given by Telephone for Patients Calling for Primary Care

This is a prospective, open label, cluster randomized trial of 2 880 expected patients who calling a French emergency medical service Dial 15 for fever or gastroenteritis symptoms during out-of-hours periods. All calls will be taken by a general practitioner (GP). Out-of-hours period is defined as 8 PM to 8 AM on weekdays, 1 PM to 8PM on Saturdays in addition to Sundays and holidays.To be exhaustive, we will enrol patients during one year.

In the experimental arm, the GP will implement a protocol of care to each patient call. The protocol includes medical advice, drug prescription by phone and supervisory board. Patients are invited to recall in case of worsening or onset of new symptoms and to get an appointment with their GP during working hours.

In the non-interventional arm, the GP will decide the need of telephone advice with or without drug prescription, home visit by a doctor, emergency department services with or without EMS system.

We will recall every patient at 15+/-4 days.

Inclusion criteria

• Disease:

• Fever: temperature ≥ 38 ° C
• Symptoms of gastroenteritis include nausea and / or vomiting and / or diarrhea
• Onset of symptoms for less than 72 hours
• Age ≥ 18 years caller
• Patient age ≥ 1 year
• Affiliation to the French National Health Service

Exclusion criteria

• Pregnancy
• Severity criteria (fever> 41 ° C, disturbance of consciousness, rash, dyspnea, signs of dehydration, chest pain, neurological signs, gastrointestinal bleeding)
• Seeking advice from institutional correspondents (fire brigade, police, airport…)
• Communication difficulties (non-communicating patient, language barrier...)