Can self-care health books affect amount of contact with the primary health care team? A randomized controlled trial in general practice

Objective: To investigate the effects of two differently styled self-care health books in general practice on the frequency and duration of patients' consultations and their views of the books.

Design: Random allocation of patients to either a descriptive or a decision-tree based self-care health book, or a no-book control condition. Three- and 12-months follow-up by postal questionnaire and monitoring of consultations.

Setting: A large general practice in the South East of England.

Subjects: A total of 1967 volunteer, adult patients who attended the practice in 2001 participated.

Main outcome measures: Demographics; health problems; use of health services; use and perceptions of the trial book; frequency and duration of consultations.

Results: Response rates to postal questionnaires at 3 and 12 months were 80% and 74%. In all, 48% consulted their allocated book, compared with 25% who consulted any healthcare book in the Control group. Those reporting health problems were more likely to have consulted their allocated book; 60% reported that the allocated book made them more likely to deal with a problem themselves and 40% reported themselves less likely to consult the practice. However, there were no differences in consultation rates or durations of consultations between the three groups.

Conclusions: Handing out of self-care health books may provide qualitative benefits for patients but is unlikely to reduce attendance at the GP practice.