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Does an encouraging letter encourage attendance at psychiatric out-patient clinics? The Leeds PROMPTS randomized study

Published online by Cambridge University Press:  15 October 2007

J. Kitcheman ,
C. E. Adams ,
A. Pervaiz ,
I. Kader ,
D. Mohandas  and
G. Brookes
J. Kitcheman
Affiliation:
Academic Department of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, UK
C. E. Adams*
Affiliation:
Academic Department of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, UK Division of Psychiatry, University of Nottingham, Duncan MacMillan House, Nottingham, UK
A. Pervaiz
Affiliation:
Calderdale and Huddersfield NHS Foundation Trust, St Luke's Hospital, Huddersfield, UK
I. Kader
Affiliation:
Leeds Mental Health Teaching NHS Trust, Bridge House, Leeds, UK
D. Mohandas
Affiliation:
Bradford District Care Trust, Bradford, UK
G. Brookes
Affiliation:
Leeds Partnerships NHS Foundation Trust, Becklin Centre, Leeds, UK
*
*Address for correspondence: Dr C. E. Adams, Associate Professor, Division of Psychiatry, University of Nottingham, Duncan MacMillan House, Portchester Road, Nottingham NG3 6AA, UK. (Email: clive.adams@nottingham.ac.uk)
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Abstract

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.

Keywords

Out-patient attendancepragmaticpsychiatryrandomized
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 5 , May 2008 , pp. 717 - 723
Copyright
Copyright © Cambridge University Press 2007

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