Behaviourally informed, patient-led interventions to reduce missed appointments in general practice: a 12-month...

Area of Science:

• Health Services Research
• Behavioural Science
• Primary Care Medicine

Background:

• Scalable, behaviourally informed interventions can improve appointment attendance and timely cancellations in primary care.
• Long-term implementation of such interventions has not been extensively studied.

Purpose of the Study:

• To assess the impact of social norms and active commitment strategies on reducing missed appointments and increasing cancellations in primary care over 12 months.
• To explore the implementation factors of these interventions within a general practice setting.

Main Methods:

• A mixed-methods study was conducted in a large GP practice, including a 6-month baseline followed by a 12-month intervention period.
• Interventions involved redesigned waiting room notices emphasizing social norms and training receptionists to elicit active commitments from patients regarding attendance or cancellation.
• Quantitative analysis compared monthly missed appointments and cancellations to baseline, while qualitative data from staff questionnaires and field notes explored implementation.

Main Results:

• The intervention resulted in a 20% reduction in monthly missed appointments (mean decrease of 37.67) and a 21.07% increase in cancellations (mean increase of 102.66) compared to baseline.
• These changes were statistically significant over the 12-month intervention period and when compared to seasonally equivalent months.
• Reception staff reported challenges in consistent implementation due to pressures, with varied knowledge and attitudes towards the strategies.

Conclusions:

• Behaviourally informed interventions are effective in reducing long-term missed appointments in primary care.
• Collaborative quality improvement projects involving Patient Participation Groups and practice teams, supported by leadership, are crucial for prioritizing and embedding new practices.