Evidence map›Paper›PMID 31748378›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2019

Non-attendance at urgent referral appointments for suspected cancer: a qualitative study to gain understanding from patients and GPs.

Laura Jefferson, Karl Atkin, Rebecca Sheridan, Steven Oliver, Una Macleod, Geoff Hall, Sarah Forbes, Trish Green, Victoria Allgar, Peter Knapp

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Behind the Screen: An Exploratory Study of Factors Influencing Breast Screening Uptake in Lancashire (UK).Health expectations : an international journal of public participation in health care and health policy · 2025
    Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Review
  10. Quantitative Evaluation of Cancer Stigma among Non-Patient Population in Oman.Asian Pacific journal of cancer prevention : APJCP · 2024
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Laura JeffersonUniversity of York, York.
Karl AtkinUniversity of York, York.
Rebecca SheridanUniversity of York, York.
Steven OliverUniversity of York, Hull York Medical School, Hull and York.
Una MacleodUniversity of Hull, Hull York Medical School, Hull and York.
Geoff HallUniversity of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds.
Sarah ForbesOakwood Lane Medical Practice, Leeds.
Trish GreenUniversity of Hull, Hull York Medical School, Hull and York.
Victoria AllgarUniversity of York, Hull York Medical School, Hull and York.
Peter KnappUniversity of York, Hull York Medical School, Hull and York.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe 2-week-wait urgent referral policy in the UK has sought to improve cancer outcomes by accelerating diagnosis and treatment. However, around 5-7% of symptomatic referred patients cancel or do not attend their hospital appointment. While subsequent cancer diagnosis was less likely in non-attenders, those with a diagnosis had worse early mortality outcomes.

aimTo examine how interpersonal, communication, social, and organisational factors influence a patient's non-attendance. DESIGN AND

settingQualitative study in GP practices in one Northern English city.

methodIn-depth, individual interviews were undertaken face-to-face or by telephone between December 2016 and May 2018, followed by thematic framework analysis.

resultsIn this study 21 GPs, and 24 patients who did not attend or had cancelled their appointment were interviewed, deriving a range of potential explanations for non-attendance, including: system flaws; GP difficulties with booking appointments; patient difficulties with navigating the appointment system, particularly older patients and those from more deprived areas; patients leading 'difficult lives'; and patients' expectations of the referral, informed by their beliefs, circumstances, priorities, and the perceived prognosis. GPs recognised the importance of communication with the patient, particularly the need to tailor communication to perceived patient understanding and anxiety. GPs and practices varied in their responses to patient non-attendance, influenced by time pressures and perceptions of patient responsibility.

conclusionFailure to be seen within 2 weeks of urgent referral resulted from a number of patient and provider factors. The urgent referral process in general practice and cancer services should accommodate patient perceptions and responses, facilitate referral and attendance, and enable responses to patient non-attendance.

Indexed as

Attitude to HealthNo-Show PatientsReferral and ConsultationAdultAgedAge FactorsAttitude of Health PersonnelCommunicationFemaleGeneral PracticeGeneral PractitionersHumansInterpersonal RelationsMaleMiddle AgedMotivationcancercommunicationdiagnosisno-show patientsprimary health caresocioeconomic factors

Identifiers

PMID31748378
PMCPMC6863680

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.