Texting appointment reminders to repeated non-attenders in primary care: randomised controlled study.
Qual Saf Health Care. 2008 Oct;17(5):373-6
Authors: Fairhurst K, Sheikh A
BACKGROUND: Failure to attend appointments compromises health service efficiency. Despite considerable interest in using novel technologies to improve attendance, evidence from rigorously conducted controlled studies is lacking. AIM: To evaluate the effectiveness of texting appointment reminders to patients who persistently fail to attend appointments. DESIGN: Randomised controlled study. SETTING: Inner city general practice in Lothian, Scotland. METHOD: We included 415 appointments made by patients (n = 173) who had failed to attend two or more routine appointments in the preceding year. Patients whose appointments were randomised to the intervention group received a text message reminder of the appointment. Patients whose appointments were in the control group received no reminder. Our primary outcome measure was non-attendance rates. We undertook an intention-to-treat analysis and multi-level analysis to take account of the lack of independence of the outcomes of repeated appointments for the same patient. RESULTS: Of the 418 appointments originally included in the study, three were excluded due to clerical error; 189 were randomised to the intervention group and 226 to the control group. Twenty-two appointments (12%) were not attended in the intervention group compared with 39 (17%) in the control group. A chi-square analysis, considering the outcome of appointments as independent from one another, gave a non-significant difference of 5% (95% CI of difference -1.1 to 12.3%, p = 0.13). Multilevel analysis applied to the binary outcome data on non-attendance gave an odds ratio for non-attendance in the intervention group compared with the control group of 0.63 (95% CI 0.36 to 1.1, p = 0.11). CONCLUSION: Although the intervention showed promise, we failed to demonstrate significant reduction in non-attendance rates, as a result of texting appointment reminders to patients who persistently fail to attend their general practice appointments.
PMID: 18842978 [PubMed - in process]
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Long-term evaluation of undergraduate family medicine curriculum in Slovenia.
Srp Arh Celok Lek. 2008 May-Jun;136(5-6):274-9
Authors: Svab I, Petek-Ster M
INTRODUCTION: In 1994, as a result of curriculum reform, the Ljubljana medical school established its first department of family medicine and introduced its first curriculum of family medicine. The new subject was well accepted by the students and the medical school. Nevertheless, there was no comprehensive analysis of the curriculum during this period. OBJECTIVE: Our aims were to assess the quality of teaching based on fulfilled expectations, pre-defined learning objectives and satisfaction in a 10-year period, and to measure changes in career preference towards family medicine. METHOD: An analysis of two sets of questionnaires, routinely given to medical students in academic years 1997/1998 and 2006/2007, was made. RESULTS: Most of the students’ expectations were met, and the level increased over ten years. The level of achievement of learning objectives has been high and increased over the ten-year period. Family medicine still receives high scores in students’ satisfaction. Although there is evidence that the family medicine curriculum is well accepted and that it improves some of the attitudes towards family medicine, it does not influence the career choice of students. CONCLUSION: The level of achievement of learning objectives increased with the experiences of the teachers. We improved the attitude of medical students toward general practice and general practitioners. We have not been successful in influencing career choice of students, which is an objective that is probably outside our reach.
PMID: 18792625 [PubMed - in process]
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Nutrition guidance in The Netherlands: the role of the GP in the translation from population strategy to individual approach.
Fam Pract. 2008 Oct 26;
Authors: Drenthen AJ, Van Binsbergen JJ
An important pitfall of nutritional guidance in medical practice is how to deal with the prevention paradox: a nutritional advice that is good for the population as a whole is not necessarily proven effective for the individual patient. Evidence-based guidelines are needed to support GPs to translate these advices to the individual patient. We illustrate this with two examples: obesity and undernutrition. The Dutch Ministry of Health started a national partnership on overweight. The role of the Dutch College of GPs (NHG) in this process is to insert the GP’s perspective and to ‘translate’ the multidisciplinary guideline into a practice guideline for GPs. A systematic review on nutritional deficiency in general practice in The Netherlands showed a prevalence ranging from 0% to 13%. The ‘National Steering Committee Undernutrition’ stimulates GPs to pay more attention to undernutrition, in collaboration with the Dutch College of GPs. The Cochrane Primary Health Care Field (Nijmegen) accommodates the Cochrane Diet and Nutrition Sub Field involving the inclusion of evidence from non-randomized studies, which are generally not included in Cochrane Reviews, but which form an important part of the evidence for the role of nutrition. From this international initiative, a national collaboration in The Netherlands between universities, researchers and the Dutch College was founded, which aims to support the foundation of practice-based nutrition counselling in the consulting room.
PMID: 18953070 [PubMed - as supplied by publisher]
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