The Importance of Recall
Patient Recall: a vital part of the monitoring process for weight management
Evaluation of weight management programmes typically considers 12 month weight change from baseline, enabling clinicians to assess the effectiveness of the intervention and compare with other programmes. Follow-up rates in the initial evaluation of Counterweight were around 50%, which is typical of lifestyle interventions. Our data from Scotland since 2007 suggests a higher loss to follow up at 12 months although a number of factors may be involved:
- Focus of the work in Scotland has been with patients not routinely engaged with general practice services
- Initial Counterweight work was with patients already engaged with general practice, and frequently already engaged with routine review for e.g. blood pressure monitoring, and diabetes review.
- Work in Scotland has largely been directed to areas of high social deprivation where attendance rates are generally lower than in more affluent areas
While these factors need to be considered we also know that attendance rates can be optimised with the adoption of processes to enable data to be collected for assessment of progress at the appropriate time points.
Options for patient review
- At the initial Counterweight visit patients will be advised that follow up visits to review progress will take place at 3,6, 9 and 12 months. While patients should be advised to remember to make an appointment to meet with these time frames, the reality is that many may forget or would be more likely to attend if invited to do so by the practice.
- Some patients already routinely engaged with general practice could have a reminder marked on their electronic medical records to have a review of their weight at their next general practice visit. This data is then also suitable for use for evaluation of progress.
- Recall systems, such as those routinely set up for other clinical monitoring such as smears, and diabetic reviews, could be set up for patients Counterweight in practices. This allows focus on patients not routinely engaged with general practice. Monthly lists of patients due for review are produced, and depending on practice protocol patients can then be sent a letter or called to advise them to make an appointment for review of progress with their weight.
Decisions around the best option for your practice are probably best made following discussion with the practice manager, IT and reception staff.
Other options such as text messages and e-mail contact are not routinely used but could be considered at a local level. We would also welcome any suggestions from you on how best to obtain this information, critical to robust evaluation of any weight management intervention.
If anyone has positive experiences of how they recall their patients, and what they have found most effective then we would be interested in hearing from you.
For further information
Please contact Louise McCombie on 07968 820081 or by email at louise.mccombie@counterweight.org