Treatment overshadowing as a reason for patient non-attendance at pelvic-floor muscle training sessions

This study explores the reasons for patient non-attendance at scheduled pelvic floor muscle training (PFMT) sessions. Although only limited research has been conducted on this topic, it is crucial to understand its implications for resources, non-attendance rates and the significance of the underlying reasons. Forty-four women were selected at random from patients with pelvic floor dysfunction who had not attended a scheduled PFMT session within the past 12 months. Semi-structured telephone interviews were used to gain information about the reasons for patient non-attendance, and three were identified by qualitative analysis. Life events and comorbidities, as well as administrative issues (e.g. not receiving the appointment letter) were found to be important. A new issue, termed “treatment overshadowing”, was also identified, i.e. the manner with which one treatment option was introduced by a referring medical practitioner interfered with the consideration of the other options. The latter has potential for further exploration and action to improve non-attendance rates at subsequent PFMT sessions.