Can non-attendance at hospital outpatients be reduced by giving patients a copy of their referral letter?

• Register: ISRCTN
• Last refreshed on: 13 January 2015
• Main ID: ISRCTN58123897
• Date of registration: 23/01/2004
• Prospective Registration: No
• Primary sponsor: Record Provided by the NHS R&D 'Time-Limited' National Programme Register - Department of Health (UK)
• Public title: Can non-attendance at hospital outpatients be reduced by giving patients a copy of their referral letter?
• Date of first enrolment: 01/12/1996
• Target sample size: 0
• Recruitment status: Completed
• URL: http://isrctn.com/ISRCTN58123897
• Study type: Interventional
• Study design: Randomised controlled trial (Not Specified)

Countries of recruitment

United Kingdom

Contacts

• Name: William Hamilton

Key inclusion & exclusion criteria

Inclusion criteria: All new referrals to all consultant specialities.
Exclusion criteria: Termination of pregnancy; referral letters which might distress the patient; inability to read.

Age minimum:
Age maximum:
Gender: Not Specified

Health Condition(s) or Problem(s) studied

Not applicable
Not Applicable

Intervention(s)

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.

Primary Outcome(s)

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(s)

Not provided at time of registration

Secondary ID(s)

PSI A-63

Source(s) of Monetary Support

NHS Primary and Secondary Care Interface National Research and Development Programme