Missed Appointments at a Diabetes Centre: Not a Small Problem.

Fundamental to optimal diabetes management is good patient self-care and regular follow-up with health professionals. Missed appointment may disrupt the continuity of diabetes care, thereby interfering with regular preventive screening and timely intervention.1 It may also affect care for other patients due to interference with scheduling, poor use of resources and negative impact on doctor-patient relationship.2 The prevalence of missed appointment at diabetes clinics varied considerably. For example, it was reported in a review by Griffi n SJ that the prevalence of non-attendance for at least a year from diabetes clinic in the United Kingdom was 4% to 8%.2 A study by Karter AJ et al1 showed that 64% of diabetic patients missed 1 or more appointments based on data from the Kaiser Permanente Diabetes Registry, whereas another study by Nuti LA et al3 reported that 16.2% of diabetic patients missed their last scheduled appointment in a medical centre. The differences could be attributed to variations in settings and lack of common measures of missed appointment. Studies have revealed a multitude of factors associated with missed appointments including age,1,4 shorter duration of diabetes,4 days from scheduling to appointment,5,6 days of week and time of appointment.5 However, information on missed appointments in patients with diabetes in Singapore remains limited. Hence, we assessed the magnitude and risk factors of missed appointments in the Diabetes Centre in our hospital, a dedicated one-stop multidisciplinary centre to provide more holistic care and where a short message service (SMS) appointment reminder system has been in place since inception. The fi ndings will enable us to account for these factors when scheduling appointments and apply appropriate strategies to encourage attendance. We conducted a retrospective cohort study of patients who fi rst attended doctor’s appointment at Diabetes Centre between 1 June 2010 and 31 May 2012. Their attendance for appointments was tracked till 31 December 2013. Missed appointments comprised scheduled appointments