Can non-attendance at hospital outpatients be reduced by giving patients a copy of their referral letter?
| ISRCTN | ISRCTN58123897 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN58123897 |
| Secondary identifying numbers | PSI A-63 |
- Submission date
- 23/01/2004
- Registration date
- 23/01/2004
- Last edited
- 18/11/2010
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Plain English Summary
Not provided at time of registration
Contact information
Dr William Hamilton
Scientific
Scientific
Barnfield Hill Surgery
12 Barnfield Hill
Exeter
EX1 1SR
United Kingdom
| Phone | +44 (0)1392 432761 |
|---|---|
| w.hamilton@cwcom.net |
Study information
| Study design | Randomised controlled trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Randomised controlled trial |
| Study setting(s) | Not specified |
| Study type | Not Specified |
| Scientific title | |
| 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(s) | Not provided at time of registration |
| 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 |
| Primary outcome measure | 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 study start date | 01/12/1996 |
| Overall study end date | 01/12/1998 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Not Specified |
| Sex | Not Specified |
| Target number of participants | Not provided at time of registration |
| Participant inclusion criteria | All new referrals to all consultant specialities. |
| 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
- England
- United Kingdom
Study participating centre
Barnfield Hill Surgery
Exeter
EX1 1SR
United Kingdom
EX1 1SR
United Kingdom
Sponsor information
Record Provided by the NHS R&D 'Time-Limited' National Programme Register - Department of Health (UK)
Government
Government
The Department of Health
Richmond House
79 Whitehall
London
SW1A 2NL
United Kingdom
| Website | http://www.doh.gov.uk |
|---|
Funders
Funder type
Government
NHS Primary and Secondary Care Interface National Research and Development Programme
No information available
Results and Publications
| Intention to publish date | |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Not provided at time of registration |
| Publication and dissemination plan | Not provided at time of registration |
| IPD sharing plan |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Results article | results | 22/05/1999 | Yes | No |
