Journal of General Internal Medicine

, Volume 28, Issue 1, pp 25–31 | Cite as

Impact of Information Leaflets on Behavior of Patients with Gastroenteritis or Tonsillitis: A Cluster Randomized Trial in French Primary Care

  • Mélanie Sustersic
  • Eva Jeannet
  • Lucile Cozon-Rein
  • Florence Maréchaux
  • Céline Genty
  • Alison Foote
  • Sandra David-Tchouda
  • Luc Martinez
  • Jean-Luc Bosson
Original Research



To assess the impact of four patient information leaflets on patients’ behavior in primary care.


Cluster randomized multicenter controlled trial between November 2009 and January 2011.


French adults and children consulting a participating primary care physician and diagnosed with gastroenteritis or tonsillitis. Patients were randomized to receive patient information leaflets or not, according to the cluster randomization of their primary care physician.


Adult patients or adults accompanying a child diagnosed with gastroenteritis or tonsillitis were informed of the study. Physicians in the intervention group gave patients an information leaflet about their condition. Two weeks after the consultation patients (or their accompanying adult) answered a telephone questionnaire on their behavior and knowledge about the condition.


The main and secondary outcomes, mean behavior and knowledge scores respectively, were calculated from the replies to this questionnaire.


Twenty-four physicians included 400 patients. Twelve patients were lost to follow-up (3 %). In the group that received the patient information leaflet, patient behavior was closer to that recommended by the guidelines than in the control group (mean behavior score 4.9 versus 4.2, p < 0.01). Knowledge was better for adults receiving the leaflet than in the control group (mean knowledge score 4.2 versus 3.6, p < 0.01). There were fewer visits for the same symptoms by household members of patients given leaflets (23.4 % vs. 56.2 %, p < 0.01).


Patient information leaflets given by the physician during the consultation significantly modify the patient’s behavior and knowledge of the disease, compared with patients not receiving the leaflets, for the conditions studied.


patient information leaflet primary care general practice patient behavior knowledge about disease 




We thank Carole Rolland for managing the study (Grenoble CIC) and Aurélia Meneau for participating in the study design. We also thank Philippe Eveillard for critically reading the manuscript. We thank the following physicians for their participation: Baud N, Blanckemane M, Boivin JE, Brin M, Constans D, Corchia L, Dauphin D, Demaret F, D’Herouville C, Dubayle V, Folacci JL, Gamby A, Gandiol J, Genthon A, Gozlan E, Guetta B, Lagabrielle D, Lamy D, Leclercq A, Moulle C, Lambert P, Magnen L, Menuret H, Poucel F, Rony N, Schihin R, Triviella F, Verjus P, Vignoulle JL, and Zerbib Y for joining us in the expert committee


The study was supported by the Grenoble Clinical Research Centre, which is financed by INSERM and French hospital funding, both belonging to the public sector. Neither INSERM nor the hospital influenced the study design, analysis or interpretation of results.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Supplementary material

11606_2012_2164_MOESM1_ESM.doc (662 kb)
ESM 1 (DOC 662 kb)


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Copyright information

© Society of General Internal Medicine 2012

Authors and Affiliations

  • Mélanie Sustersic
    • 1
    • 9
  • Eva Jeannet
    • 2
  • Lucile Cozon-Rein
    • 3
  • Florence Maréchaux
    • 4
  • Céline Genty
    • 5
  • Alison Foote
    • 6
  • Sandra David-Tchouda
    • 7
  • Luc Martinez
    • 8
  • Jean-Luc Bosson
    • 5
  1. 1.Clinical Research CentreUniversity Hospital and Clinique Mutualiste/UJF-Grenoble 1/CNRS/TIMC-IMAG UMR 5525/ThemasGrenobleFrance
  2. 2.General PracticeMarseilleFrance
  3. 3.General PracticeGrenobleFrance
  4. 4.General PracticeParis 10France
  5. 5.UJF-Grenoble 1/CNRS/Clinical Research CentreUniversity Hospital and Inserm CIC03/TIMC-IMAG UMR 5525/ThemasGrenobleFrance
  6. 6.Clinical Research CentreGrenoble University Hospital and Inserm CIC03GrenobleFrance
  7. 7.Clinical Research CentreUniversity Hospital/UJF-Grenoble 1/CNRS/TIMC-IMAG UMR 5525/ThemasGrenobleFrance
  8. 8.Department of Family medicinePierre and Marie Curie UniversityParisFrance
  9. 9.Pôle Santé Publique, Pavillon TaillferCHU GrenobleGrenoble cedex 9France

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