Telephone triage by triage nurses is efficient but possibly not safe, with potentially severe consequences for the patient. An educational programme for triage nurses is recommended. Also, a direct second safety check of all cases by a specially trained GP telephone doctor is advisable.

Objective. To determine the impact of urinary incontinence (UI) on the quality of life of the elderly in the general population and to identify factors with the greatest effect. Design. Qualitative and quantitative analyses of interview data. Setting . Patients from the nine family practices of the Nijmegen University Research Network. Subjects. Independently living patients aged 60 and over. Main outcome measures. All independently living patients aged 60 and over with uncomplicated UI were interviewed at home using the Incontinence Impact Questionnaire and open-ended questions. Results. In total, 56 men and 314 women were interviewed. A majority do not have such an impact. In the Incontinence Impact Questionnaire (IIQ) emotional well-being was most affected. Half to one-third of the patients felt nervous, embarrassed, or frustrated because of their incontinence. In the social domain ''clothing'' and ''fear of odour'' scored the highest impact. The most affected practical consequence in the IIQ was ''going to places where you are not sure about the availability of a toilet'' followed by ''travelling longer than 20 minutes'' and ''entertainment''. Men reported higher impact scores than women, despite the fact that incontinence was less severe in men. The most important effect of incontinence reported in men was ''being out of control'' while most women considered ''feeling impelled to take several precautions'' to be the most important consequence of UI. Conclusion. UI affects nearly half of patients, particularly as regards their emotional wellbeing and in public activities. Men experienced more impact compared with women and experienced loss of control more often than women.

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Familiarity with a GP improves patients' assessment of general practice care. Also in the future, personal continuity should be promoted.

Objective To examine the extent to which the family influences individual use of general practitioner care. Design Retrospective cohort study of all consultations in one calendar year. Multilevel modelling was used to analyse contact frequencies of individuals within families within practices. Setting General practice in the Netherlands. Participants 42 262 families with children aged 2-21 years registered in 96 practices. Main outcome measures Family influence on individual frequency of contact with general practice and correlation in frequency of contacts between parents and children. Results After correction for patients' age and sex, analysis of siblings indicates that 22% of the variance in frequencies of contact can be ascribed to influence of the family. This means that contact frequencies of family members within families resemble each other, whereas differences in contact frequencies exist between families. Almost 6% of the variance refers to differences between practices and 73% of the variance refers to individual differences. The strongest correlations were found between mothers and children and between children. Conclusions The extent of shared help seeking behaviour within families has considerable implications in the context of the practice.