Prevalence and predictors of no-shows to physical therapy for musculoskeletal conditions

Abstract

Objectives Chronic pain affects 50 million Americans and is often treated with non-pharmacologic approaches like physical therapy. Developing a no-show prediction model for individuals seeking physical therapy care for musculoskeletal conditions has several benefits including enhancement of workforce efficiency without growing the existing provider pool, delivering guideline adherent care, and identifying those that may benefit from telehealth. The objective of this paper was to quantify the national prevalence of no-shows for patients seeking physical therapy care and to identify individual and organizational factors predicting whether a patient will be a no-show when seeking physical therapy care. Design Retrospective cohort study. Setting Commercial provider of physical therapy within the United States with 828 clinics across 26 states. Participants Adolescent and adult patients (age cutoffs: 14–117 years) seeking non-pharmacological treatment for musculoskeletal conditions from January 1, 2016, to December 31, 2017 (n = 542,685). Exclusion criteria were a primary complaint not considered an MSK condition or improbable values for height, weight, or body mass index values. The study included 444,995 individuals. Primary and secondary outcome measures Prevalence of no-shows for musculoskeletal conditions and predictors of patient no-show. Results In our population, 73% missed at least 1 appointment for a given physical therapy care episode. Our model had moderate discrimination for no-shows (c-statistic:0.72, all appointments; 0.73, first 7 appointments) and was well calibrated, with predicted and observed no-shows in good agreement. Variables predicting higher no-show rates included insurance type; smoking-status; higher BMI; and more prior cancellations, time between visit and scheduling date, and between current and previous visit. Conclusions The high prevalence of no-shows when seeking care for musculoskeletal conditions from physical therapists highlights an inefficiency that, unaddressed, could limit delivery of guideline-adherent care that advocates for earlier use of non-pharmacological treatments for musculoskeletal conditions and result in missed opportunities for using telehealth to deliver physical therapy.

Effect of COVID-19 pandemic on missed medical appointment among adults with chronic disease conditions in Northwest Ethiopia

“…This finding was inconsistent with previous studies conducted elsewhere [14,26,27]. On the other hand, the finding was supported by previous studies: claimed that older age increases the likelihood of canceling medical appointments [28][29][30]. This may be because older patients have a higher risk of developing a severe form of COVID-19 compared to younger patients.…”

“…Patients with a longer duration of the illness were more likely to miss their medical appointments. This may be due to that patients who lived a long time with the disease condition may have good self-care of their illness and therefore they may have better confidence in managing their illness by themselves [ 29 ], Therefore, they may cancel their medical appointments more likely to patients with shorter duration of the illness.…”

Factors impacting adherence to an exercise-based physical therapy program for individuals with low back pain

“…Another barrier to adherence that we identified was lack of financial and geographic accessibility to care, including lack of sufficient health insurance coverage for the prescribed treatment duration. Although health insurance related factors and geographic location have not been previously identified as barriers to adherence, one recent study investigating risk factors for physical therapy visit cancellations or “no-shows” reported that insurance type and clinic location were significant predictors of not showing up for physical therapy visits [ 55 ], and these two factors are repeatedly cited as barriers to participating in clinical trials research [ 30 ]. Although “no-shows” and adherence are not identical constructs, and as stated previously, clinical trials and clinical practice behave differently, these findings highlight the potential impact of socioeconomic factors on care accessibility and compliance.…”

Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown—Individual Observation

“…However, telemedicine-oriented patient education may well solve the problem [37,61,62]. Studies conducted for virtual consultations for orthopedics usually focus on new solutions and technologies [59,[63][64][65][66][67][68][69], patient and clinician satisfaction [4,24,26,46,49,[70][71][72][73][74][75][76][77], clinical outcome measures [78][79][80][81][82], and cost analysis of traditional versus teleconsultation [82][83][84][85][86][87].…”