Patient-Reported Attributions for Missed Colonoscopy Appointments in Two Large Healthcare Systems

Bhise, Viraj; Modi, Varsha; Kalavar, Anisha; Espadas, Donna; Hanser, Loretta; Gould, Milena; El–Serag, Hashem B.; Singh, Hardeep

doi:10.1007/s10620-016-4096-3

Cited by 32 publications

(42 citation statements)

References 29 publications

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“…Limitations in this study include that the majority of eligible participants did not participate in the study due to either declining participation or being unreachable by phone. This is a common finding in similar studies [8,10,12], and this population likely represents an essential group to study further. In addition, though the interview guides "yes or no" questions were based on the literature, they might have limited participants' responses to the researchers' areas of focus.…”

Section: Limitationssupporting

confidence: 54%

“…The script began with the open-ended question, “Could you tell me about why you missed your appointment?” So that participants could speak in their own words. The interview proceeded with a series of “yes/no” questions designed to identify additional factors that may have contributed to non-attendance, based on reasons for non-attendance previously identified in the literature [ 10 , 12 , 14 , 15 ]. Participants were encouraged to expand upon their “yes” or “no” answers and these explanations were also recorded.…”

Section: Methodsmentioning

confidence: 99%

“…However, there is a wide discrepancy in findings across studies, and even across clinics within a single health system [ 7 ]. When patients have been asked about reasons for non-attendance at clinical appointments, studies have identified a variety of reasons including transportation problems [ 9 – 11 ], financial difficulties [ 11 ], being unable to take time from work [ 9 , 12 , 13 ], childcare and family commitments [ 9 , 14 ], long clinic wait times [ 9 , 11 ], being hospitalized or too ill to attend [ 9 – 11 ], prioritizing other health problems [ 12 ], and forgetting [ 10 – 12 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Into the Storm: a Mixed Methods Evaluation of Reasons for Non-attendance of Appointments in the Free Clinic Setting

Bedford

Weintraub

Dow

2020

SN Compr. Clin. Med.

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Non-attendance of healthcare appointments impact individual health outcomes and the capacity and financial stability of clinics. While non-attendance of appointments has been associated with a variety of factors, interventions to increase attendance have had mixed success. The most widely used intervention, reminder systems like phone calls or text messages, generally improves attendance rates but is insufficient for many clinics as a sole intervention. This study of underresourced patients who did not attend appointments at two clinics for uninsured individuals describes the multifactorial, individualized, and interacting reasons for non-attendance among these methods: Forty-three patients were interviewed by phone within 3 weeks of missing a clinic appointment using a scripted interview based on the literature. Responses were coded and analyzed. For 57% of respondents, a competing priority such as work or caregiving was a reason for missing an appointment. Forgetting about the appointment was a barrier for 38% of participants despite reminder systems being in place. Contributions to non-attendance were identified through thematic analysis: emotional and physical exhaustion, prioritization of work over healthcare, unreliable transportation, financial stress, and being unaware of an appointment. These findings demonstrate the need to test multiple patient-centered interventions, particularly in the context of underresourced communities. Keywords Appointments and schedules. Health services accessibility. Medically uninsured. Vulnerable populations. Continuity of patient care. Primary care. Ambulatory care facilities. Reminder systems. Patient navigation This article is part of the Topical Collection on Medicine

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Section: Limitationssupporting

confidence: 54%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Into the Storm: a Mixed Methods Evaluation of Reasons for Non-attendance of Appointments in the Free Clinic Setting

Bedford

Weintraub

Dow

2020

SN Compr. Clin. Med.

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“…Endoscopy is more invasive and time-intensive than a mammogram, and typically takes longer to schedule, leaving more opportunity for attrition and gaps in care. 25,28,30 Patient factors also may contribute. Although many patients find mammograms uncomfortable, colonoscopy preparation and procedures are typically considered more unpleasant and require patients to be escorted home, which could limit test adherence.…”

Section: Discussionmentioning

confidence: 99%

Comparing Diagnostic Evaluations for Rectal Bleeding and Breast Lumps in Primary Care: a Retrospective Cohort Study

et al. 2019

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“…The reasons for the low uptake are the invasive nature of the procedure, with severe complications in around two of every 1000 colonoscopies (14,15), and the need for extensive bowel preparation in advance of the examination. Other factors repeatedly shown to hold patients back from making an appointment for screening colonoscopy include lack of awareness of the options for screening (16), unawareness of the familial risk (17)(18)(19), incorrect assumptions regarding the procedure (20,21), inadequate communication within the family (22), and socioeconomic factors (23,24).…”

mentioning

confidence: 99%

Invitation to Screening Colonoscopy in the Population at Familial Risk for Colorectal Cancer

Bauer

Riemann

Seufferlein

et al. 2018

Deutsches Ärzteblatt International

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Background: Screening colonoscopy can lower the incidence of colorectal cancer (CRC), yet participation rates are low even in groups at high risk. The goal of this study was to double the rate of participation in screening colonoscopy among persons at familial risk and then to determine the frequency of neoplasia in this risk group. Methods: In a nationwide, cluster-randomized, multicenter study, first-degree relatives (FDR) of patients with CRC across Germany received written informational materials concerning the familial risk of CRC, along with an invitation to undergo colonoscopy. Participants in the intervention group were additionally counseled by nurses over the telephone. The primary endpoint of the study was colonoscopy uptake within 30 days. Results: The participants' mean age was 50.8 years. The colonoscopy uptake rates were 99/125 (79%) in the intervention group and 97/136 (71%) in the control group (RR = 1.11; 95% confidence interval [0.97; 1.28]). A polypectomy was performed in 72 of 196 asymptomatic persons (37%). In 13 cases (7%), an advanced neoplasia was detected; two of these persons had colon cancer (stages T0 and T1). 42% of the participants expressed barriers against colonoscopy. 22 reported mild side effects; there were no serious side effects. Conclusion: Additional counseling by nurses over the telephone does not increase the participation rate. Approaching patients who have CRC is an opportunity to increase the participation of their first-degree relatives in screening colonoscopy. The frequency of neoplasia that was found in this study underscores the need to screen relatives even before they reach the usual age threshold for screening.

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Patient-Reported Attributions for Missed Colonoscopy Appointments in Two Large Healthcare Systems

Cited by 32 publications

References 29 publications

Into the Storm: a Mixed Methods Evaluation of Reasons for Non-attendance of Appointments in the Free Clinic Setting

Into the Storm: a Mixed Methods Evaluation of Reasons for Non-attendance of Appointments in the Free Clinic Setting

Comparing Diagnostic Evaluations for Rectal Bleeding and Breast Lumps in Primary Care: a Retrospective Cohort Study

Invitation to Screening Colonoscopy in the Population at Familial Risk for Colorectal Cancer

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