Prevalence and predictors of no-shows to physical therapy for musculoskeletal conditions.

dc.contributor.author

Bhavsar, Nrupen A

dc.contributor.author

Doerfler, Shannon M

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Giczewska, Anna

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Alhanti, Brooke

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Lutz, Adam

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Thigpen, Charles A

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George, Steven Z

dc.contributor.editor

Rushton, Alison

dc.date.accessioned

2021-06-01T18:16:03Z

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2021-06-01T18:16:03Z

dc.date.issued

2021-01

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2021-06-01T18:16:00Z

dc.description.abstract

Objectives

Chronic pain affects 50 million Americans and is often treated with non-pharmacologic approaches like physical therapy. Developing a no-show prediction model for individuals seeking physical therapy care for musculoskeletal conditions has several benefits including enhancement of workforce efficiency without growing the existing provider pool, delivering guideline adherent care, and identifying those that may benefit from telehealth. The objective of this paper was to quantify the national prevalence of no-shows for patients seeking physical therapy care and to identify individual and organizational factors predicting whether a patient will be a no-show when seeking physical therapy care.

Design

Retrospective cohort study.

Setting

Commercial provider of physical therapy within the United States with 828 clinics across 26 states.

Participants

Adolescent and adult patients (age cutoffs: 14-117 years) seeking non-pharmacological treatment for musculoskeletal conditions from January 1, 2016, to December 31, 2017 (n = 542,685). Exclusion criteria were a primary complaint not considered an MSK condition or improbable values for height, weight, or body mass index values. The study included 444,995 individuals.

Primary and secondary outcome measures

Prevalence of no-shows for musculoskeletal conditions and predictors of patient no-show.

Results

In our population, 73% missed at least 1 appointment for a given physical therapy care episode. Our model had moderate discrimination for no-shows (c-statistic:0.72, all appointments; 0.73, first 7 appointments) and was well calibrated, with predicted and observed no-shows in good agreement. Variables predicting higher no-show rates included insurance type; smoking-status; higher BMI; and more prior cancellations, time between visit and scheduling date, and between current and previous visit.

Conclusions

The high prevalence of no-shows when seeking care for musculoskeletal conditions from physical therapists highlights an inefficiency that, unaddressed, could limit delivery of guideline-adherent care that advocates for earlier use of non-pharmacological treatments for musculoskeletal conditions and result in missed opportunities for using telehealth to deliver physical therapy.
dc.identifier

PONE-D-20-34506

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1932-6203

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1932-6203

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https://hdl.handle.net/10161/23311

dc.language

eng

dc.publisher

Public Library of Science (PLoS)

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PloS one

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10.1371/journal.pone.0251336

dc.title

Prevalence and predictors of no-shows to physical therapy for musculoskeletal conditions.

dc.type

Journal article

duke.contributor.orcid

Alhanti, Brooke|0000-0003-4243-8062

duke.contributor.orcid

Thigpen, Charles A|0000-0003-2487-1399

duke.contributor.orcid

George, Steven Z|0000-0003-4988-9421

pubs.begin-page

e0251336

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5

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School of Medicine

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Duke Clinical Research Institute

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Orthopaedics

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Duke

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Institutes and Centers

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Clinical Science Departments

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Published

pubs.volume

16

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