An overview of interventions to improve compliance with appointment keeping for medical services

Article Abstract:

Patients who receive reminders of medical or psychology clinic appointments may keep more appointments than those who do not receive reminders. A review of 164 articles in the medical literature found that patients kept an average of 58% of scheduled medical or psychology clinic appointments. Patients attended more appointments when they were mailed reminders or received telephone reminders of medical or psychology clinic appointments. An 'orientation statement' that provided the patient with information about the reason for the appointment and clinic organization increased patient attendance to psychology clinic appointments, but not to medical appointments. Contracts with patients to to attend future appointments increased attendance to both medical and psychology clinic appointments by at least 14%. More patients underwent screening tests when their physician was sent a computer-generated message that identified patients visiting the clinic who needed tests. Patients who miss medical appointments receive inadequate medical care, inconvenience other patients, and contribute to the rising cost of medical care.

Planning, Medical appointments and schedules, Medical scheduling

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Evidence for the effectiveness of CME: a review of 50 randomized controlled trials

Article Abstract:

A study of 777 articles evaluating continuing medical education showed that methods that satisfy physician needs were the most effective in improving physician performance and patient treatment. Case discussion workshops and opportunities to practice behaviors were more effective than lectures. With these methods, physicians improved counselling methods, resource utilization and emphasis on disease prevention. Small group learning did not cause as much change, possibly because of undirected discussion or inadequate course design. Chart review integrated learning, self assessment, reminders, feedback and the opportunity to give and receive suggestions. Examples from educational opinion leaders were effective as well. Patient education and computerized practice-based information caused changes in medical practice. Guidelines alone did not.

Evaluation, Medicine, Practice, Medical practice, Continuing education, Medical education

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Is this patient taking the treatment as prescribed?

Article Abstract:

Non-compliance with drug treatment regimens may not only reduce their effectiveness but also worsen the patient's prognosis. Compliance among patients ranges widely from 0% to 100% with an average rate of 50%. Compliance with short-term therapies such as antibiotics initially averages about 75% but then drops off considerably. Compliance drops as the regimen becomes more complicated, expensive and longer. One of the main indicators of non-compliance is failure to attend scheduled appointments. Lack or loss of response to a treatment dosage that is usually adequate or was previously adequate is another sign of non-compliance. Asking patients about their compliance in a manner that is not judgmental or threatening is probably the simplest and quickest way to determine compliance.

Measurement, Drug utilization, Drug monitoring

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