Does an encouraging letter encourage attendance at psychiatric out-patient clinics? The Leeds PROMPTS randomized study.
BACKGROUND
The aim was to reduce non-attendance for first-time consultations at psychiatric out-patient clinics.


METHODS
The study was a pragmatic randomized controlled trial; the setting was seven inner-city UK out-patient clinics in Leeds. The participants were 764 subjects of working age with an appointment to attend a psychiatric out-patient clinic for the first time. The intervention was an 'orientation statement' letter delivered 24-48 h before the first appointment compared with standard care. The primary outcome measure was attendance at the first appointment; secondary outcomes included hospitalization, transfer of care, continuing attendance, discharge, presentation at accident and emergency and death by 1 year.


RESULTS
Follow-up was for 763 out of 764 subjects (>99%) for primary and for 755 out of 764 subjects (98.8%) of secondary outcome data. The orientation statement significantly reduced the numbers of people failing to attend [79 out of 388 v. 101 out of 376 subjects, relative risk 0.76, 95% confidence interval (CI) 0.59-0.98, number needed to treat 16, 95% CI 10-187].


CONCLUSIONS
Prompting people to go to psychiatric out-patient clinics for the first time encourages them to attend. Pragmatic trials within a busy working environment are possible and informative.
Kitcheman
J
J
Academic Department of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, UK.
Adams
C E
CE
Pervaiz
A
A
Kader
I
I
Mohandas
D
D
Brookes
G
G
D000328:Adult; D003155:Community Mental Health Centers / Q000706:statistics & numerical data*; D015709:Correspondence as Topic; D004739:England; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D009042:Motivation; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D017010:Reminder Systems