Reasons for and consequences of missed appointments in general practice in the UK: questionnaire survey and prospective review of medical records

Background Missed appointments are a common occurrence in primary care in the UK, yet little is known about the reasons for them, or the consequences of missing an appointment. This paper aims to determine the reasons for missed appointments and whether patients who miss an appointment subsequently consult their general practitioner (GP). Secondary aims are to compare psychological morbidity, and the previous appointments with GPs between subjects and a comparison group. Methods Postal questionnaire survey and prospective medical notes review of adult patients missing an appointment and the comparison group who attended appointments over a three week period in seven general practices in West Yorkshire. Results Of the 386 who missed appointments 122 (32%) responded. Of the 386 in the comparison group 223 (58%) responded, resulting in 23 case-control matched pairs with complete data collection. Over 40% of individuals who missed an appointment and participated said that they forgot the appointment and a quarter said that they tried very hard to cancel the appointment or that it was at an inconvenient time. A fifth reported family commitments or being too ill to attend. Over 90% of the patients who missed an appointment subsequently consulted within three months and of these nearly 60% consulted for the stated problem that was going to be presented in the missed consultation. The odds of missing an appointment decreased with increasing age and were greater among those who had missed at least one appointment in the previous 12 months. However, estimates for comparisons between those who missed appointments and the comparison group were imprecise due to the low response rate. Conclusion Patients who miss appointments tend to cite practice factors and their own forgetfulness as the main reasons for doing so, and most attend within three months of a missed appointment. This study highlights a number of implications for future research. More work needs to be done to engage people who miss appointments into research in a meaningful way

An exploration of the representation of South Asian people in clinical trials

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

An exploration of the representation of South Asian people in clinical trials

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Complementary and alternative medicine (CAM) use among South Asian patients with cancer in Britain

Complementary and alternative medicines (CAM) form an increasing part of the cancer management programmes for some patients, despite the continuing marginalised status of such medicines within the Western medical model. Research highlights the use of CAM among South Asian settlers in the UK who also constitute a group prone to rising rates of cancer. This paper argues that it is important to establish the exact parameters and patterns of the use of CAM and its relationships to allopathic medicine among South Asian patients with cancer, in the light of patient-centred re-evaluations of the Western medical model as a way of investigating the impact of the relationship on health outcomes.