BACKGROUND: The aim was to reduce non-attendance for first-time consultations at psychiatric out-patient clinics. METHOD: The study was a pragmatic randomized controlled trial; the setting was seven inner-city UK out-patient clinics in Leeds. The participants were 764 subjects of working age with an appointment to attend a psychiatric out-patient clinic for the first time. The intervention was an 'orientation statement' letter delivered 24-48 h before the first appointment compared with standard care. The primary outcome measure was attendance at the first appointment; secondary outcomes included hospitalization, transfer of care, continuing attendance, discharge, presentation at accident and emergency and death by 1 year. RESULTS: Follow-up was for 763 out of 764 subjects (>99%) for primary and for 755 out of 764 subjects (98.8%) of secondary outcome data. The orientation statement significantly reduced the numbers of people failing to attend [79 out of 388 v. 101 out of 376 subjects, relative risk 0.76, 95% confidence interval (CI) 0.59-0.98, number needed to treat 16, 95% CI 10-187]. CONCLUSIONS: Prompting people to go to psychiatric out-patient clinics for the first time encourages them to attend. Pragmatic trials within a busy working environment are possible and informative.
RCT Entities:
BACKGROUND: The aim was to reduce non-attendance for first-time consultations at psychiatric out-patient clinics. METHOD: The study was a pragmatic randomized controlled trial; the setting was seven inner-city UK out-patient clinics in Leeds. The participants were 764 subjects of working age with an appointment to attend a psychiatric out-patient clinic for the first time. The intervention was an 'orientation statement' letter delivered 24-48 h before the first appointment compared with standard care. The primary outcome measure was attendance at the first appointment; secondary outcomes included hospitalization, transfer of care, continuing attendance, discharge, presentation at accident and emergency and death by 1 year. RESULTS: Follow-up was for 763 out of 764 subjects (>99%) for primary and for 755 out of 764 subjects (98.8%) of secondary outcome data. The orientation statement significantly reduced the numbers of people failing to attend [79 out of 388 v. 101 out of 376 subjects, relative risk 0.76, 95% confidence interval (CI) 0.59-0.98, number needed to treat 16, 95% CI 10-187]. CONCLUSIONS: Prompting people to go to psychiatric out-patient clinics for the first time encourages them to attend. Pragmatic trials within a busy working environment are possible and informative.
Authors: Mark Olfson; Ramin Mojtabai; Nancy A Sampson; Irving Hwang; Benjamin Druss; Philip S Wang; Kenneth B Wells; Harold Alan Pincus; Ronald C Kessler Journal: Psychiatr Serv Date: 2009-07 Impact factor: 4.157
Authors: Kaisa Kauppi; Maritta Välimäki; Heli M Hätönen; Lauri M Kuosmanen; Katja Warwick-Smith; Clive E Adams Journal: Cochrane Database Syst Rev Date: 2014-06-17
Authors: Sionnadh Mairi McLean; Andrew Booth; Melanie Gee; Sarah Salway; Mark Cobb; Sadiq Bhanbhro; Susan A Nancarrow Journal: Patient Prefer Adherence Date: 2016-04-04 Impact factor: 2.711