Brief report: Factors affecting outpatient follow-up compliance of emergency department patients

Kyriacou, Demetrios N.; Handel, Dan; Stein, Adam C.; Nelson, Regina R.

doi:10.1111/j.1525-1497.2005.0216_1.x

Cited by 100 publications

(80 citation statements)

References 10 publications

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“…This is especially prevalent in inner city hospital catchment area where patients often wait until development of severe symptoms before presenting for medical care [23,24]. Therefore, diagnosis of ectopic pregnancies warrens a high index of suspicion and treatment plans that are individualized, particularly to area of services with attention to patient compliance [25,26].…”

Section: Discussionmentioning

confidence: 99%

Untitled

2016

OGIJ

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Background: During the first trimester of pregnancy, ectopic pregnancy is the leading cause of maternal mortality. Diagnosis and management of ectopic pregnancies require that health care providers maintain vigilance. Providing a variety of surgical and medical treatments at night can be challenging to the on call team in a teaching hospital. We present four cases of ectopic pregnancies managed over a 15 hour period by the night on call gynecology team.Cases: Case 1, 26-year-old women diagnosed with a ruptured ectopic pregnancy that required emergent laparotomy and blood transfusion. In Case 2, 27-year-old women underwent dilation, curettage and minimal invasive surgery of operative laparoscopy for ruptured ectopic pregnancy. In Case 3, a 24-year-old woman with unruptured ectopic pregnancy was treated with methotrexate. In Case 4, 35 yearold women underwent minimal invasive operative laparoscopy for unruptured ectopic pregnancy. Conclusion:Despite technological advances in early diagnosis of ectopic pregnancy with the use of transvaginal sonogram and serial β-HCG titers, patients still present to the emergency department with ruptured ectopic pregnancy necessitating acute surgical interventions. This is especially prevalent in inner city hospital catchment area where patients often wait until development of severe symptoms before presenting for medical care. Therefore, diagnosis of ectopic pregnancies warrens a high index of suspicion and treatment plans that are individualized, particularly to area of services with attention to patient compliance.

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Section: Discussionmentioning

confidence: 99%

Untitled

2016

OGIJ

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“…[1][2][3][4][5] Although the reasons for missing appointment are complex, the most commonly cited reason is simple forgetfulness. [6][7][8][9][10][11][12][13] Mailed reminders, phone calls, and case managers can increase follow-up adherence, but these solutions can be costly and timeconsuming. [14][15][16][17][18][19][20] Automated text messages may maximize the benefit associated with reminding patients about post-ED follow-up, while minimizing cost and personnel requirements.…”

Section: Discussionmentioning

confidence: 99%

“…Although the factors leading to poor follow-up adherence are complex, across all socioeconomic demographics patients commonly report that they were unaware that missed appointments had been scheduled or that confusion regarding the date, time, or location of a scheduled appointment caused failure to attend. [6][7][8][9] The single most common reason reported by patients for missing appointments is that they were simply forgotten. [10][11][12][13] Strategies including case management, mailed reminders, and phone calls have been shown to improve attendance at outpatient follow-up appointments.…”

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confidence: 99%

Improving Attendance at Post–Emergency Department Follow‐up Via Automated Text Message Appointment Reminders: A Randomized Controlled Trial

Arora¹,

Burner²,

Terp³

et al. 2014

Academic Emergency Medicine

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Objectives: Patients discharged from the emergency department (ED) are often referred for primary care, specialty, or other disease-specific follow-up appointments. Attendance at these scheduled followup appointments has been found to improve patient outcomes, decrease ED bounce-backs, and reduce malpractice risk. Reasons for missing follow-up visits are complex, but the most commonly reason cited by patients is simply forgetting. In this study the authors evaluated the ability of an automated text message reminder system to increase attendance at post-ED discharge follow-up appointments in a predominantly Hispanic safety-net population.Methods: This was a randomized controlled trial of ED patients with outpatient follow-up visits scheduled at the time of ED discharge. A total of 374 English-and Spanish-speaking patients with textcapable mobile phones were enrolled. Patients in the intervention arm received automated, personalized text message appointment reminders including date, time, and clinic location at 7, 3, and 1 day before scheduled visits. A t-test of proportions was used to compare outcomes between intervention and control groups. Both an intention-to-treat (ITT) and a per-protocol analysis of the data were performed. The ITT more accurately reflects real-world conditions where errors such as number entry errors are bound to occur. The per-protocol analysis adds value by isolating the effect of the intervention by comparing patients who actually received it compared with those who did not.Results: In the per-protocol analysis of the primary outcome, the overall appointment adherence rate was 72.6% in the intervention group compared with 62.1% in the control group (difference between groups = 10.5%, 95% confidence interval [CI] = 0.3% to 20.8%; p = 0.045; number needed to treat = 9.5). In the ITT analysis, the overall appointment attendance rate 70.2% in the intervention group compared with 62.1% in the control group (difference between groups = 8.2%; 95% CI = -1.6% to 17.7%; p = 0.100). In a secondary largely exploratory analysis, the intervention was found to have the most benefit in patients with the lowest baseline follow-up rate (English speakers with specialty care appointments).Conclusions: Automated text message appointment reminders resulted in improvement in attendance at scheduled post-ED discharge outpatient follow-up visits and represent a low-cost and highly scalable solution to increase attendance at post-ED follow-up appointments, which should be further explored in larger sample sizes and diverse patient populations.ACADEMIC EMERGENCY MEDICINE 2015;22:31-37

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“…Si bien Grafft no encontró diferencias en reingresos entre los pacientes de medicina general con control post alta documentado y no documentado, Kyriacou encontró que los primeros tuvieron una mayor probabilidad de cumplir el plan de alta (p < 0,001) 56,57 . Van Walvaren encontró que el control post alta con el médico del hospital puede reducir las muertes y los reingresos a los 30 días en comparación al médico de atención primaria (HR 0,95; IC de 95% = 0,95-0,96) o al especialista (HR 0,97; IC de 95% = 0,97-0,98) 58 .…”

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