Background Our weekly difficult asthma clinic consistently has a higher ‘did not attend’ (DNA) rate compared to the general respiratory clinics (32.6% v 23.7%). There is some evidence that DNA rates are particularly high for primary care asthma reviews¹. Demand for our weekly difficult asthma clinic appointments is increasing such that routine appointments are at a premium. To explore reasons for non-attendance, our asthma specialist nurses attempted to interview patients that DNA over the telephone within a week of their scheduled appointment. The cause for non-attendance was ascertained in a non-confrontational manner and asthma control gauged.

Aim To determine reasons preferred for non-attendance at a difficult asthma clinic and to ascertain whether these differed between new and follow-up patients.

Methods Review of database generated from contacting patients that DNA asthma clinic between April 2011 and March 2012.

Results There were a total of 153 missed appointments. We attempted to contact the patient following their missed appointment in 101 cases and were able to succesfully complete a telephone interview in 51 cases. Of the DNA appointments, 8 were new-patient appointments and 43 were follow-up.

See Table 1. Reasons for non-attendance.

Conclusions Forgetfulness (‘wrong day’ and ‘forgot’) was the commonest reason for non-attendance amongst both new and follow-up patients. This is in keeping with work done in the general out-patient population.2 One in 5 patients claimed not to have recieved their appointment. Attempts to telephone patients a week prior to their scheduled appointment may help to reduce DNA rates and/or make more appoinments available to patients that need them.

References

1. van Baar et al, Understanding reasons for asthma outpatient (non)-attendance and exploring the role of telephone and e-consulting in facilitating access to care: exploratory qualitative study Qual Saf Health Care 2006; 15:191–195

2. Pal et al, Why do outpatients fail to keep their clinic appointments? Results from a survey and recommended remedial actions. Int J Clin Pract.1998 Sep; 52(6):436–7.