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Non-attendance at diabetes outpatient appointments: a systematic review

Non-attendance at diabetes outpatient appointments: a systematic review
Non-attendance at diabetes outpatient appointments: a systematic review

Background: Non-attendance at diabetes outpatient appointments is a sizeable problem worldwide and has been associated with suboptimal health outcomes. We aimed to describe the characteristics, health outcomes and reasons given for non-attendance at doctor- or nurse-led diabetes appointments, and interventions to improve attendance. Methods: PubMed, EMBASE, CINAHL and PsychInfo were searched from database inception to February 2019. Included articles were peer-reviewed, published in English, related to adults or young people with type 1 or type 2 diabetes, and addressed one of the above aspects of non-attendance. Studies were excluded if reporting on other types of diabetes or reviewing attendance at structured education, retinal screening, paediatric, antenatal, podiatry or dietetic clinics. Results: Thirty-four studies of varied designs were identified (15 observational, 1 randomized control trial, 9 qualitative, 5 surveys, 4 service improvements). The definition of non-attendance varied. Younger adults, smokers and those with financial pressures were less likely to attend. Non-attendance was associated with higher HbA 1c; other outcomes were varied but typically worse in non-attenders. Reasons for non-attendance in qualitative studies fell into three categories: balancing the costs and benefits of attendance, coping strategies, and the relationships between the person with diabetes and healthcare professionals. Interventions included appointment management strategies, service improvements, patient navigators and WebCam appointments. Conclusions: Non-attendance is only partially explained by logistical issues. Qualitative studies suggest complex psychosocial factors are involved. Interventions have progressed from simple appointment reminders in an attempt to address some of the psycho-social determinants, but more work is needed to improve attendance.

0742-3071
1427-1442
Brewster, Sarah
d2f1b45f-e5e4-4fa5-91c0-92df50772c83
Bartholomew, Jazz
2264ba13-20c3-48ff-94eb-6ec49ee9a7c6
Holt, Richard
d54202e1-fcf6-4a17-a320-9f32d7024393
Price, Hermione
2d0a0ee9-39fe-4723-92c9-bacfe2dffc94
Brewster, Sarah
d2f1b45f-e5e4-4fa5-91c0-92df50772c83
Bartholomew, Jazz
2264ba13-20c3-48ff-94eb-6ec49ee9a7c6
Holt, Richard
d54202e1-fcf6-4a17-a320-9f32d7024393
Price, Hermione
2d0a0ee9-39fe-4723-92c9-bacfe2dffc94

Brewster, Sarah, Bartholomew, Jazz, Holt, Richard and Price, Hermione (2020) Non-attendance at diabetes outpatient appointments: a systematic review. Diabetic Medicine, 37 (9), 1427-1442. (doi:10.1111/dme.14241).

Record type: Review

Abstract

Background: Non-attendance at diabetes outpatient appointments is a sizeable problem worldwide and has been associated with suboptimal health outcomes. We aimed to describe the characteristics, health outcomes and reasons given for non-attendance at doctor- or nurse-led diabetes appointments, and interventions to improve attendance. Methods: PubMed, EMBASE, CINAHL and PsychInfo were searched from database inception to February 2019. Included articles were peer-reviewed, published in English, related to adults or young people with type 1 or type 2 diabetes, and addressed one of the above aspects of non-attendance. Studies were excluded if reporting on other types of diabetes or reviewing attendance at structured education, retinal screening, paediatric, antenatal, podiatry or dietetic clinics. Results: Thirty-four studies of varied designs were identified (15 observational, 1 randomized control trial, 9 qualitative, 5 surveys, 4 service improvements). The definition of non-attendance varied. Younger adults, smokers and those with financial pressures were less likely to attend. Non-attendance was associated with higher HbA 1c; other outcomes were varied but typically worse in non-attenders. Reasons for non-attendance in qualitative studies fell into three categories: balancing the costs and benefits of attendance, coping strategies, and the relationships between the person with diabetes and healthcare professionals. Interventions included appointment management strategies, service improvements, patient navigators and WebCam appointments. Conclusions: Non-attendance is only partially explained by logistical issues. Qualitative studies suggest complex psychosocial factors are involved. Interventions have progressed from simple appointment reminders in an attempt to address some of the psycho-social determinants, but more work is needed to improve attendance.

Text
Non-attendance systematic review REVISED tracked changes removed- 19.11.2019 without appendix - Accepted Manuscript
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More information

Accepted/In Press date: 16 January 2020
e-pub ahead of print date: 22 January 2020
Published date: 1 September 2020
Additional Information: Funding Information: The authors acknowledge Professor Jane Portlock, Visiting Professor of Pharmacy Practice, University of Portsmouth, and Paula Sands, Research Engagement Librarian, University of Southampton. Publisher Copyright: © 2020 Diabetes UK

Identifiers

Local EPrints ID: 436612
URI: http://eprints.soton.ac.uk/id/eprint/436612
ISSN: 0742-3071
PURE UUID: b4bd3f2e-20b2-473b-8340-7a9f1d97bb24
ORCID for Richard Holt: ORCID iD orcid.org/0000-0001-8911-6744

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Date deposited: 18 Dec 2019 17:30
Last modified: 06 Aug 2022 04:01

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Contributors

Author: Sarah Brewster
Author: Jazz Bartholomew
Author: Richard Holt ORCID iD
Author: Hermione Price

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