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Efficient use of clinic resources and timely and appropriate patient care are necessary for sustainability.
The use of clinic letters limits exploring the symptomatology in patients, although we (PP/PJG) have been interested in the question of premonitory symptoms over the period of review, which has standardised to a large extent what is recorded.
They also showed a higher percentage use of clinic and pharmacy/self-medication, suggesting a balance in the use of healthcare systems.
Depending on the reference period, the effect of free care on use of clinic visits is 3.6 percentage points to 5.4 percentage points smaller with the household data.
Training in the use of clinic tools and equipment and verbal recognition by employer or community are predictors for both areas of performance – quite a finding for the study.
Guidelines to date have tended to recommend the use of clinic measurement with ambulatory blood pressure monitoring and, to a lesser extent, home monitoring as secondary methods in special cases such as white coat hypertension.
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One might argue that the use of clinic-based case-control studies should be minimized in favor of population-based case-control cohorts or family studies as more robust designs for avoiding possible confounding and biases [25], [26].
The use of clinic-ePRO/home-ePRO was in general shown to be feasible and well accepted.
In addition, the actual estimate of adherence may be inflated by use of clinic-based medication measures.
The use of clinic-based patient recruitment provided medical verification of opioid dosage and additional information about pain and concomitant medication use and comorbid conditions.
Work in this area could build on the AMIA Guidelines for the Use of Clinic-Patient Electronic Mail [ 71] and should complement the efforts of the Markle Foundation's Connecting for Health initiative.
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