Condition category
Not Applicable
Date applied
23/01/2004
Date assigned
23/01/2004
Last edited
18/11/2010
Prospective/Retrospective
Retrospectively registered
Overall trial status
Completed
Recruitment status
No longer recruiting

Plain English Summary

Not provided at time of registration

Trial website

Contact information

Type

Scientific

Primary contact

Dr William Hamilton

ORCID ID

Contact details

Barnfield Hill Surgery
12 Barnfield Hill
Exeter
EX1 1SR
United Kingdom
+44 (0)1392 432761
w.hamilton@cwcom.net

Additional identifiers

EudraCT number

ClinicalTrials.gov number

Protocol/serial number

PSI A-63

Study information

Scientific title

Acronym

Study hypothesis

Despite waiting lists, approximately 12% of people do not attend their hospital outpatient appointment (new and follow-up). A pilot randomised study of 171 consecutive new referrals from two general practitioners suggested that a simple device - sending them a copy of their referral letter - markedly reduced the proportion of non-attenders, from 6% in the control group to zero in their intervention group. The aim of this research is to try and confirm this finding in a wider sample of general practitioners and their populations.
1. The attempt to reduce non-attendance by a primary care intervention as opposed to all previous work which has applied secondary care interventions.
2. The innovation of sending patients routinely a copy of their referral letter.

Ethics approval

Not provided at time of registration

Study design

Randomised controlled trial

Primary study design

Interventional

Secondary study design

Randomised controlled trial

Trial setting

Not specified

Trial type

Not Specified

Patient information sheet

Condition

Not applicable

Intervention

All general practitioners in Exeter city (n=71) except one on sabbatical and one of the authors (WH), were invited to participate. Forty-four showed an interest, of whom 26, representing 13 of the 19 practices, were selected using a random numbers table. All 2078 referrals to consultants in the two local trusts between January and May, 1997 were eligible.

Intervention type

Other

Phase

Not Specified

Drug names

Primary outcome measures

The main outcome measure was the number of non-attendances at new outpatient appointments, either as a first time non-attendance, or non-attendance at a rearranged appointment. Attendances were monitored by two methods. The general practitioners¿ records were examined by WH, while blinded to copy/control status, for written replies from the hospital team. Deaths and hospital admissions were documented. Notes of patients who died were obtained from the North and East Devon Health Authority, who also provided details of the new general practitioner when patients had changed practices. The new general practitioner extracted attendance data from their records. The general practitioner is not routinely notified of cancellations, and some departments do not notify a first non-attendance. For these hospital data was used. The large majority of consultant referrals from Exeter general practitioners are to the Royal Devon and Exeter Healthcare Trust. All outpatient appointment outcomes are coded in the hospital Patient Activity System as attendance, cancellation or non-attendance. In addition to finding cancellations and unnotified non-attendances, this dataset was compared with attendance data from the general practitioner¿s notes. Non-attendance rates for study and non-study general practitioners before, during and after the trial were calculated, to assess the representativeness of study general practitioners.

Secondary outcome measures

Not provided at time of registration

Overall trial start date

01/12/1996

Overall trial end date

01/12/1998

Reason abandoned

Eligibility

Participant inclusion criteria

All new referrals to all consultant specialities.

Participant type

Patient

Age group

Not Specified

Gender

Not Specified

Target number of participants

Not provided at time of registration

Participant exclusion criteria

Termination of pregnancy; referral letters which might distress the patient; inability to read.

Recruitment start date

01/12/1996

Recruitment end date

01/12/1998

Locations

Countries of recruitment

United Kingdom

Trial participating centre

Barnfield Hill Surgery
Exeter
EX1 1SR
United Kingdom

Sponsor information

Organisation

Record Provided by the NHS R&D 'Time-Limited' National Programme Register - Department of Health (UK)

Sponsor details

The Department of Health
Richmond House
79 Whitehall
London
SW1A 2NL
United Kingdom

Sponsor type

Government

Website

http://www.doh.gov.uk

Funders

Funder type

Government

Funder name

NHS Primary and Secondary Care Interface National Research and Development Programme

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Results - basic reporting

Publication summary

1999 results in http://www.ncbi.nlm.nih.gov/pubmed/10334750

Publication citations

  1. Results

    Hamilton W, Round A, Sharp D, Effect on hospital attendance rates of giving patients a copy of their referral letter: randomised controlled trial., BMJ, 1999, 318, 7195, 1392-1395.

Additional files

Editorial Notes