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Heroin Addiction and Related Clinical Problems: 2022, 24, N3 (pages: 29 - 32)

Improving Attendance in Addictions. Do Quality Improvement Plans Work?

Mayet S., Shahbaz S., and Arshad S.

Summary: Background. Opioid dependence has high risks and opioid agonist treatment improves outcomes. Addiction prescribers monitor prescribing, but nonattendance is high. We started a quality improvement plan to increase attendance at addiction prescriber consultations. Aim. To increase attendance at addiction prescriber appointments using a Quality Improvement Plan and assess whether this is effective over a year after implementation. Methods. Humber Teaching NHS Foundation Trust Quality Improvement Plan. We assessed attendance rates at baseline in April 2018, and implemented a Quality Improvement Plan to improve attendance, with an updated appointment letter and keyworker face-to-face reminder. We re-assessed attendance in a subsample and implemented an enhanced Quality Improvement Plan in October 2018 with additional text message and telephone reminders. We reviewed attendance 3 months later in December 2018 and 15 months later. Results. In April 2018, 50% patients attended. After the Quality Improvement Plan (letter and keyworker reminder) in Oct 2018 (subsample) there was no change. Enhanced Quality Improvement Plan with text and telephone reminders implemented and attendance increased to 76% by Dec 2018. Attendance rates were further improved (84%) in subsample in Jan 2020. Conclusions. An enhanced Quality Improvement Plan with text and telephone reminders improved attendance, with effects sustained for over a year. Strategies such as texts reminders are likely to be beneficial across a range of healthcare services for improving attendance.