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.
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
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.