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Predictors of Missed Research Appointments in a Randomized Placebo-Controlled Trial
StÚphanie J.E. Becker, MD1; Thierry Guitton2; David C. Ring, MD, PhD1; (1)Massachusetts General Hospital, (2)Academic Medical Center
Massachusetts General Hospital, Boston, MA, USA

Introduction:The primary aim of this study was to determine predictors of missed appointments in a prospective randomized placebo-controlled trial with evaluations 1-3 and 5-8 months after enrollment.

Materials & Methods: One hundred and four patients were enrolled in a prospective randomized controlled trial of dexamethasone versus lidocaine (placebo) injection for various diagnoses. Sixty-three patients had lateral epicondylosis, 17 had trapeziometacarpal (TMC) arthrosis, and 24 had de Quervain tenosynovitis. Bivariate and multivariable analyses were used to determine factors associated with missed appointments.

Results:Seventeen percent did not return for the first visit after injection and 36 percent did not return for the second visit after injection. Five patients that missed the initial visit returned for the second visit. Factors associated with missing the first visit included younger age (r = 0.25, p = 0.011), single status (p = 0.043), greater pain intensity (r = 0.25, p = 0.012), lower Chance Health Locus of Control (CHLC) scale score (r = 0.29, p = 0.0026), and higher PCS score (r = 0.23, p = 0.047). Age, pain, and CHLC were retained in the final multivariable model, which explained 32% of the variance in missing the first visit. Factors associated with missing the second appointment included diagnosis of lateral epicondylosis (p = 0.026), lower Internal Health Locus of Control (IHLC; r = 0.23, p = 0.019), and higher Eysenck Personality Questionnaire (EPQ-R) psychoticism subscale score (r = 0.34, p = 0.0021). The best multivariable model retained the IHLC score and the EPQ-R psychoticism subscale score, and explained 22% of the variance in missed appointments.

Conclusions: Younger patients, patients with greater pain, and patients who believe their health can be controlled (lower CHLC) are more likely to miss a follow-up appointment when enrolled in a prospective randomized placebo-controlled trial.


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