PT  - JOURNAL ARTICLE
AU  - Paule, Armina
AU  - Abel, Gary A
AU  - Parsons, Jo
AU  - Atherton, Helen
TI  - Patient-facing online triage tools and clinician decision-making: a systematic review
AID  - 10.1136/bmjopen-2024-094068
DP  - 2025 May 01
TA  - BMJ Open
PG  - e094068
VI  - 15
IP  - 5
4099  - http://bmjopen.bmj.com/content/15/5/e094068.short
4100  - http://bmjopen.bmj.com/content/15/5/e094068.full
SO  - BMJ Open2025 May 01; 15
AB  - Objective To evaluate the role of using outputs from patient-facing online triage tools in clinical decision-making in primary care.Design Systematic review.Data sources Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Scopus were searched for literature published between 1 January 2002 and 31 December 2022 and updated for literature published up to end of November 2024.Eligibility criteria for selecting studies Studies of any design are included where the study investigates how primary care clinicians make clinical decisions in response to patient concerns reported using online triage tools.Data extraction and synthesis Data were extracted, and quality assessment was conducted using the Mixed Methods Appraisal Tool. Narrative synthesis was used to analyse the findings.Results 14 studies were included, which were conducted in the UK (n=9), Sweden (n=3) and Spain (n=2). There were no studies that examined clinical decision-making as an outcome. Outcomes relating to the impact on clinical decision-making were grouped into three categories: patient clinical outcomes (n=9), primary care practitioner experience (n=11) and healthcare system outcomes (n=14). Studies reported faster clinical decisions made in response to patient concerns. Other studies reported clinicians offering unnecessary urgent appointments as patients learnt to ‘game’ the system. Clinicians felt confident managing patient requests as they can access additional information (such as a photo attachment). Moreover, clinicians’ time was freed up from appointments with limited clinical value. Contrarily, online triage was perceived as an additional step in the workflow.Conclusion Clinicians should be aware that their decision-making processes are likely to differ when using online triage tools. Developers can use the findings to improve the usability of the tools to aid clinical decision-making. Future research should focus on patient-facing online triage tools in general practice and the process of clinical decision-making.PROSPERO registration number CRD42022373944.All data relevant to the study are included in the article or uploaded as supplementary information.Relevant data are included in online supplemental tables.