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FAILURE TO ATTEND FOLLOW UP APPOINTMENTS IN PATIENTS WITH COLORECTAL CANCER – HOW COMMONLY DOES IT OCCUR AND WHY?
Author(s) -
Shimokawa K.,
Shedda S.,
Pem A.,
Jones I.,
Gibbs P.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04915_25.x
Subject(s) - medicine , attendance , colorectal cancer , disease , cancer , family medicine , pediatrics , economics , economic growth
Follow up after curative resection for colorectal cancer has been demonstrated to improve survival and failure to attend (FTA) may compromise patient outcomes. The incidences of FTA and the causes have not been documented. Methods: Patients were identified from a prospective clinical database and a hospital based appointment system. FTA follow up was defined as non‐attendance of at least one appointment, within 5 years post operatively. A phone interview was used to evaluate the cause. Patients from a non‐English speaking background (NESB) were contacted with interpreters. Results: From January 2003 to May 2008 622 patients with stage I‐III cancer were identified, including 202 from a NESB. 125 non‐attendees were identified. 61 patients (70%) were contacted from 87 surviving patients. 26 could not be located and 38 patients were deceased. Of the 61 patients studied, 32(52%) were male. The mean age was 68 years (range 33, 102). 14 patients (23%) were from a NESB. Each non‐attendant averaged 16 appointments, and 1.7 failed attendances. A median of > 13 months elapsed from diagnosis to 1st missed appointment. The main reasons for non attendance were: unaware of the appointment (n = 21), inconvenience due to time or travel (n = 14), poor health (n = 10), long waiting times (n = 8), forgetting (n = 6) and other (n = 2). Age, sex and number of booked appointments were not associated with non‐attendance. Conclusion: Failure to attend follow‐up appointments is common. Overall, access to follow up was prevented by structural factors more than disease/patient factors. A common reason for non‐attendance was that patients were unaware of the appointment. Opportunities for significantly improving attendance include a reminder system.