Non-attendance at drug service Hepatitis C outreach clinics:clients and staff experiences.

摘要: Non-attendance in the drug service hepatitis C outreach clinic means clients miss essential components of care: being offered lifestyle advice such as limiting their alcohol intake (to prevent further progression liver disease);a discussion about ways to avoid transmission others; and referral for hospital treatment, which can be curative. In absence much empirical evidence many suggestions have been given missed appointments by patients. For example, they forget, lead ‘chaotic lifestyles’, infection is ‘not a priority’ them are ‘hard-to-reach’. This study was undertaken investigate beneath these ‘surface’ reasons non-attendance. Thus, realist approach taken. The comprised three phases theory development testing that incorporated qualitative telephone interviews with followed national survey staff. All 28 who participated gave or ‘prima-facie’ However, revealed hidden underlying factors (mechanisms). These were categorised under themes: (i) ‘client characteristics’ e.g. ‘priority’ score drugs ‘cost travel’ (ii) ‘hepatitis C’ ‘no symptoms’ fear treatment ‘side-effects’ (iii) ‘clinic service’ ‘distance’ difficulty ‘reimbursement’ travel expenses. mechanisms produced within complex context including addiction, welfare policy stigma. They often played out different linked other mechanisms. 41 142 (29%) services England ran clinic. There general agreement nonattendance. However, there some discordance, notably with walking. picture non-attendance makes an original contribution knowledge appointments. turn has informed changes to practice may engage more people into care arranging scans on day