Summary Background Nonattendance to scheduled appointments in outpatient clinics is a frequent problem in ambulatory medicine with an impact on health systems and patients' health. The characterization of nonattendance is fundamental for the design of appropriate strategies for its management. Aims To identify causes of nonattendance of scheduled ambulatory medical appointments by adult patients. Methods Case and two controls study nested in a prospective cohort. A telephone‐administered questionnaire was applied within the first 72 hours to identify the causes of attendance, nonattendance, or cancellation in patients who had a scheduled appointment to which they had been present, absent, or cancelled. Results A total of 150 absences (cases), 176 attendances, and 147 cancellations (controls) in a prospective cohort of 160 146 scheduled appointments (2012/2013) were included. According to self‐reports in telephone interviews, the most frequent causes of nonattendance were forgetting 44% (66), unexpected competing events 15.3% (23), illness or unwellness 12% (18), work‐related inconvenience 5.3% (8), transport‐related difficulties 4.7% (4), and cause that motivated appointment scheduling already resolved 4.7% (4). Discussion The main cause of nonattendance is forgetting the scheduled appointment, but there is a proportion of different causes that do not respond to reminders but could respond to different strategies.
Background Primary Care Physiotherapy Units attend patients derived by primary care physicians with the next care circumstances: degenerative osteomuscular disease, specially spinal osteoarthritis; but also pain located in shoulder, knee, hand and hip. Pathology of ligaments (sprains), tendinitis and bursitis are also treated. The physiotherapists of the primary care unit don’t treat pathology produced by trauma (fractures), or neuronal disease. Patients receive 10 sessions of physical therapy lasting about 50 minutes and involving the application of different techniques assessed by the physiotherapist depending on location, pathology and severity of injury: Treatment procedures available include:cryotherapy, thermotherapy, electrotherapy (like Transcutaneous Electrical Nervous Stimulation or TENS), exercise (joint range, strengthening, re-education), manual therapy, and postural hygiene. Objectives To describe the population who received treatment in a Primary Care Physiotherapy Unit, the type of pathology treated, and to quantify the improvement in pain reduction after treatment. Methods Design: An observational retrospective study was used. Subjects: All the patients attended during a year. Setting: Primary Care Physiotherapy Unit. from an urban Primary Care Centre. Variables assessed: age, sex, disease for which is derived for treatment, pain reduction and poortreatmentcompletion. Results Out of 867 people were attended in the Physiotherapy Unit. 71,9% of them were women. The standard age rate was 61,13 (± 16,37), and the age status was from 16 to 90 years old. The attended pathologies in order of frequency were: neck pain (29,5%), low back pain (25,3%), shoulder pain (21,2%), knee pain (9,1%), dorsal back pain (4,8%), hand pain (3,%); sprains (2,9%), tendinitis (2,2%) and hip pain (1,5%). After 10 sessions of physiotherapy, effectiveness of treatment is seen by significant reduction of pain in 53,1%, partial reduction in 39,2%, and no noticeable improvement in 1,2%. The dropout rate was 6,5%. Conclusions The profile of patients seen at the physiotherapy unit of primary care is that of a middle-aged woman (61 years) presenting degenerative spinal disease. The physical therapy is highly effective in the reduction of the pain (92% of the patients recounts some improvement and only 6,5% did not finish the treatment). Primary Care Physiotherapy Units greatly reduce referral to the second level of care and improve user accessibility and quality of life. References Gόmez-Conesa, A; Abril Belchí, E. Physiotherapy Activity of Spinal Diseases in Primary Healthcare. Fisioterapia. 2006; 28(4):217-25 Abril E, Gόmez A, Gutierrez –Santos M. Assessment and improvement of the care protocol for patients with lumbar pathology in a primary health care physiotherapy unit. Rev Calidad Asistencial 2008; 23 (3): 109-13 Disclosure of Interest None Declared
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