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Prompt letters to reduce non-attendance: applying evidence based practice
Mahesh Jayaram1, Ranganath D Rattehalli, Ihsan Kader
1Leeds Partnerships NHS Foundation Trust, Bridge House, Balm Road, Leeds LS10 2TP, UK. Mahesh.Jayaram@leedspft.nhs.uk
BMC Psychiatry
|November 19, 2008
Summary
Sending prompting letters to psychiatric outpatients significantly reduced non-attendance rates. This simple, evidence-based intervention offers potential cost savings and improves service quality by ensuring more patients attend appointments.
Area of Science:
- Psychiatric outpatient care
- Healthcare quality improvement
- Evidence-based practice
Background:
- High non-attendance rates in psychiatric clinics impact service quality and patient outcomes.
- Failed appointments increase healthcare costs and lead to treatment delays.
- Previous trials indicated prompting letters could decrease patient no-shows.
Purpose of the Study:
- To evaluate the impact of sending prompting letters on non-attendance rates in a community mental health setting.
- To assess the effectiveness of this evidence-based practice under real-world conditions.
Main Methods:
- A before-and-after study design was employed.
- Prompting letters were sent to all outpatients scheduled for appointments over six months in 2007.
- Non-attendance rates were compared to the same period in 2006.
Main Results:
- Prompting letters were sent to 1433 outpatients.
- The average non-attendance rate decreased from 27% in 2006 to 17% in 2007 (RR 0.65).
- No pre-existing downward trend in non-attendance was observed.
Conclusions:
- Prompting letters effectively reduced non-attendance rates in a community mental health setting, consistent with previous trial findings.
- This intervention is easily applicable and demonstrates that results from pragmatic trials can be replicated in non-randomized settings.
- Prompt letters represent a valuable, cost-effective strategy for improving outpatient appointment adherence.
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