NCT03793972: TRIAGE

Triaging and Referring in Adjacent General and Emergency Departments

Completed NA Results posted Last updated 11 March 2025

What this trial tests

NA trial testing Triage with referral to primary care in Triage in 8,158 participants. Completed in 31 December 2019.

Timeline

4 January 2019

Primary endpoint
31 December 2019

31 December 2019

Quick facts

Lead sponsor	Universiteit Antwerpen
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	none
Primary purpose	health services research
Enrollment	8,158
Start date	4 January 2019
Primary completion	31 December 2019
Estimated completion	31 December 2019
Sites	2 locations across Belgium

Drugs / interventions tested

• Triage with referral to primary care
• Usual care

Conditions studied

• Triage — all drugs for Triage →

Sponsor

Universiteit Antwerpen — full company profile →

Who can join

Eligibility, any sex, with Triage. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

The Proportion of Patients Presenting at the ED But Being Treated by the GPC After Referral Primary · Patient flow will be followed for 24 hours after presentation at the ED

The difference between intervention and control period will be calculated. Treatment at the GPC means having a record at the GPC.

Group	Value	95% CI
Triage With Referral to Primary Care	599
Triage Without Referral to Primary Care	0

Adverse events — posted to ClinicalTrials.gov

Time frame: For the individual patient: only during their stay at the emergency department or general practice cooperative.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Triage With Referral to Primary Care

Serious: 1/6294 (0%)

Deaths: 1/6294

Triage Without Referral to Primary Care

Serious: 0/1744 (0%)

Deaths: 0/1744

Serious adverse events (1 terms)

Reaction	System	Triage With Referral to Pr…	Triage Without Referral to…
Ruptured Abdominal Aortic Artery	Blood and lymphatic system disorders	—	—

Most-reported serious reactions: Ruptured Abdominal Aortic Artery.

Data from ClinicalTrials.gov NCT03793972 adverse events section.

Sponsor's own description

Introduction: Patients who might also go to the general practitioner (GP) frequently consult emergency departments (ED). This leads to additional costs for both government and patient and a high workload for emergency physicians in Flanders. The Belgian government wants to address this problem by improved collaboration between EDs and general practice cooperatives (GPCs).

Intervention: Patients presenting at the ED during out-of-hours (OOH) will be triaged and allocated to the most appropriate service. For this purpose the Manchester Triage System (MTS) which is commonly used in Flemish hospitals, will be extended (eMTS). By doing so a trained nurse will be able to diverge suitable patients towards the GPC.

Methodology: The investigators will conduct a cluster randomised controlled trial in which eligible ED patients will be diverged to the GPC using the eMTS. The investigators will collect data using the iCAREdata database. The investigators will study the use of the eMTS, the effectiveness and effects of triage, work load changes, epidemiology at both departments, patient safety, health insurance (HIS) and patient expenditures. Furthermore, facilitators and barriers will be studied and an incident analysis of problem cases will be performed.

Outcome: The primary outcome is the proportion of patients who enter the ED and are handled by the GP after triage. Secondary outcome measurements are related to safety: referral rate to the ED by the GP, proportion of patients not following the triage advice and file review for selected patients.

Publications & conference data

5 peer-reviewed publications reference this trial (live from Europe PMC):

1. Triaging and referring in adjacent general and emergency departments (the TRIAGE trial): A cluster randomised controlled trial.
   Morreel S, Philips H, De Graeve D, Monsieurs KG, et al · · 2021 · cited 10× · PMID 34731198 · DOI 10.1371/journal.pone.0258561
2. Information campaigns and trained triagists may support patients in making an appropriate choice between GP and emergency department.
   Philips H, Verhoeven V, Morreel S, Colliers A, et al · · 2019 · cited 4× · PMID 31663392 · DOI 10.1080/13814788.2019.1675630
3. Non-compliance with a nurse's advice to visit the primary care provider: an exploratory secondary analysis of the TRIAGE-trial.
   Homburg I, Morreel S, Verhoeven V, Monsieurs KG, et al · · 2022 · cited 3× · PMID 35395840 · DOI 10.1186/s12913-022-07904-8
4. Differences in emergency nurse triage between a simulated setting and the real world, post hoc analysis of a cluster randomised trial.
   Morreel S, Verhoeven V, Philips H, Meysman J, et al · · 2022 · PMID 35777880 · DOI 10.1136/bmjopen-2021-059173
5. Triaging and Referring In Adjacent General and Emergency Departments (the TRIAGE trial): a cluster randomised controlled trial
   Morreel S, Philips H, De Graeve D, Monsieurs KG, et al · · 2021 · DOI 10.1101/2021.08.16.21261782