Reasons for patient no-shows and drop-offs after initial evaluation in physical therapy outpatient care: a qualitative study

Background

No-shows and drop-offs by patients after their initial physical therapy evaluation can significantly impact clinics and therapists. To our knowledge, no previous studies have examined the patient's perspective of why they terminated their recommended plan of care after only attending their initial evaluation.

Objective

To gain insights regarding why patients do not follow through on a recommended physical therapy plan of care after the initial evaluation.

Methods

This qualitative study used semi-structured phone interviews with patients who received a physical therapy evaluation for a musculoskeletal condition within a large regional healthcare system. Participants were purposefully sampled if they attended their initial evaluation, did not attend a follow-up visit within 30 days, and had no future appointments scheduled. After data collection and transcription, coding and thematic analysis took place to establish primary and secondary themes.

Results

A total of 26 interviews were conducted, including 12 males and 14 females, with an average age of 51.04 (± 15.72) years. Five common themes emerged, including clinical improvement at an acceptable rate (23.1 %), access issues (26.9 %), did not see value or could do therapy on their own (23.1 %), other medical management was needed (15.4 %), and patient-provider relationship issues (11.5 %).

Conclusion

These findings highlight the patient's rationale for not following through on a physical therapist's recommended plan of care after an initial evaluation. They may help practice managers and clinicians to proactively address barriers, clinic access issues, and evaluation strategies to maximize the patient's follow-through on their plan of care.