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BACKGROUND: Botulinum toxin treatments have been associated with consistently high patient satisfaction rates, but calculation of patient retention rates is not routinely performed. Retention measurements serve as critical indicators of clinical performance and can be optimized by evaluation of current office policies and implementation of strategies to improve patient retention. PURPOSE: To investigate the reasons patients discontinue botulinum toxin treatments and to evaluate the effect of a single intervention intended to improve patient retention. METHODS: A retrospective chart review was performed of all patients who received botulinum toxin injections in a private cosmetic dermatology practice over a 2-year time period to determine the patient retention rate. Patients who had discontinued botulinum toxin treatment after a single session were surveyed to discern their reasons for terminating treatment. A change in office policy was instituted wherein all patients who received their first botulinum toxin treatment were required to undergo a 2-week post-treatment evaluation to determine treatment effect and to receive touch-up treatment as necessary. Retention rates were calculated over the 1-year period immediately after initiation of the new policy. RESULTS: The initial patient retention rate was 55%. The most common reasons cited for discontinuance of botulinum toxin treatments were procedural cost, patient failure to re-schedule, perceived lack of product longevity, and clinical effect falling short of expectations. After initiation of the mandatory 2-week post-treatment office evaluation, a 67% patient retention rate was achieved. CONCLUSIONS: Managing patient expectations of botulinum toxin treatments and mandatory post-treatment appointments for evaluation of the initial procedure increase the patient retention rate. 相似文献
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Andrews G 《Obesity surgery》1996,6(5):426-429
Background: A psychological profile of the average bariatric patient demonstrates psychopathology that may contribute to patient
noncompliance with post-surgical treatment guidelines. Methods and results: Patient psychopathology is analysed with regard
to noncompliance and its contribution to poor surgical outcome. The interpersonal process approach is reviewed as a psychotherapeutic
framework that provides interventions to patient psychopathology. Conclusions: Treatment of patient psychopathology with the
interpersonal process approach encourages postsurgical compliance and helps patients succeed. 相似文献
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《Arthroscopy》2022,38(12):3207-3208
Adapting Tolstoy, “Satisfied patients are all alike; every dissatisfied patient is dissatisfied in their own way.” We need to learn the reasons why patients are dissatisfied. Whereas happy patients receive the same procedures for similar indications as unhappy patients, evidence supports a clear association between negative psychological function and worse preoperative and postoperative patient-reported outcome measures. Thus, the unhappy patient might be where we can make most improvement in patient care. The first step could be to standardize reasons for patient displeasure, such as adverse events, poor patient-reported outcomes, failure to meet the patient acceptable symptomatic state, failure to return to sport or work at the same level, or failure to meet patient’s expectations. Next, when possible, modifiable factors should be addressed preoperatively. Next, we should evaluate whether addressing modifiable factors (i.e., depression or smoking) improves outcome. Clinicians should be mindful of patient psychosocial and refer for treatment of modifiable factors when possible. 相似文献
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C. R. Musgrave N. A. Pilch D. J. Taber H. B. Meadows J. W. McGillicuddy K. D. Chavin P. K. Baliga 《American journal of transplantation》2013,13(3):796-801
Greater than 50% of medication errors are estimated to occur during transitions of care, and solid‐organ transplant recipients are at an increased risk for errors due to significant changes in their medication regimen following transplantation. This prospective, observational study with a historical control group was conducted to evaluate the discharge process for transplant recipients and determine if transplant pharmacist involvement would improve safety. During the prospective period, a total of 191 errors were made on discharge medication reconciliations (n = 64, mean rate 3.0 per patient); however, pharmacists prevented 119 of these errors (1.9 errors per patient). In the retrospective period, none of the 430 errors identified were prevented at the time of discharge (n = 128, p < 0.0001). The 72 errors not prevented at the time of discharge in the prospective cohort were identified by the pharmacist at the patient's first clinic visit (1.1 errors per patient). In the historical cohort, all 430 errors made at discharge persisted until at least the time of the first clinic visit (3.4 errors per patient, p < 0.0001). This study demonstrates that transplant recipients are at a high risk for medication errors and that transplant pharmacist involvement leads to improved safety through the significant reduction of medication errors. 相似文献
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Janes RM 《Annals of surgery》1955,142(1):134-135
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《Arthroscopy》2021,37(9):2754-2755
Platelet-rich plasma (PRP) injections continue to be used at increasing rates to treat common musculoskeletal conditions. PRP has a low-risk profile and emerging in vitro evidence to support its positive effects on soft-tissue healing. PRP has been shown to be of benefit for knee osteoarthritis, but less has been published regarding the shoulder. PRP delivers a high concentration of growth factors, cytokines, and other important inflammatory modulators. Its use is appealing for treating partial-thickness rotator cuff tears, subacromial bursitis, and rotator cuff tendinopathy since rotator cuff tendons often have poor healing capacity due to intrinsic degeneration. PRP has been shown to increase cell proliferation and matrix synthesis in tenocytes, which may aid tendon regeneration and healing. Adult tendons also contain a small amount of tendon progenitor cells, which can be induced to an active state by PRP. In addition, PRP is an autologous biologic agent and easy to acquire and administer in an outpatient clinical setting. Clinical studies continue to lag and are often heterogenous in quality and in results. PRP can vary widely based on multiple intrinsic and extrinsic factors, including patient age, sex, activity level, centrifugation speed, and number of centrifugation cycles. Thus, quality research methods should include reporting using the PAW (platelets/activation/white blood cells) system. Clinicians should remain cautiously optimistic about the future role of PRP injections in the shoulder. 相似文献