Factors associated with missed appointments by adults with type 2 diabetes mellitus: a systematic review

Abstract

Keeping regular medical appointments is a key indicator of patient engagement in diabetes care. Nevertheless, a significant proportion of adults with type 2 diabetes mellitus (T2DM) miss their regular medical appointments. In order to prevent and delay diabetes-related complications, it is essential to understand the factors associated with missed appointments among adults with T2DM. We synthesized evidence concerning factors associated with missed appointments among adults with T2DM. Using five electronic databases, including PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and Web of Science, a systematic literature search was done to identify studies that describe factors related to missed appointments by adults with T2DM. A total of 18 articles met the inclusion criteria. The majority of studies included in this review were cohort studies using medical records. While more than half of the studies were of high quality, the operational definitions of missed appointments varied greatly across studies. Factors associated with missed appointments were categorized as patient characteristics, healthcare system and provider factors and interpersonal factors with inconsistent findings. Patient characteristics was the most commonly addressed category, followed by health system and provider factors. Only three studies addressed interpersonal factors, two of which were qualitative. An increasing number of people live with one or more chronic conditions which require more careful attention to patient-centered care and support. Future research is warranted to address interpersonal factors from patient perspectives to better understand the underlying causes of missed appointments among adults with T2DM.

Using the Health Belief Model to Explain the Experience of Diabetic Patients About Referring to Rural Health Centers

“…About 12 -36% of patients with type 2 diabetes missed regular appointments. Understanding the distributing factors of regular appointments can improve diabetes care in patients with diabetes (14,15).…”

“…Results of this review showed that a variety of multilevel factors is associated with an irregular appointment in this population with inconsistency in findings. They found that most of the published reports examined patients' features and ignored the role of interpersonal factors (14). Davoodi et al in a Qualitative Study explored barriers and incentive factors for patients with type 2 diabetes to refer urban health center of Ahvaz.…”

Longitudinal Associations Between Illness Perceptions and Glycemic Control in Type 2 Diabetes

“…It is associated with inadequate adherence to medication and self-monitoring of blood glucose and suboptimal glycemic control, which all contribute to life-threatening diabetes-related complications [40]. Systematic reviews have identified several factors associated with clinic nonattendance, including patient factors (e.g., socioeconomic status, knowledge, health literacy, and health beliefs, and perceptions), disease-related factors (e.g., treatment regimen, comorbidities, and HbA1c level), and healthcare provider factors (e.g., poor communication, long interval to appointment, and healthcare provider's attitudes and behaviors) [38,[41][42][43]. Healthcare providers and systems should utilize a range of interventions that are known to reduce clinic nonattendance both at the patient level (e.g., SMS and telephone reminders) and the healthcare system level (e.g., clinician continuity, efficient register, and recall system and online clinics) [38,41,44,45].…”

Adverse childhood event subtypes and routine diabetes care utilization among U.S. adults with Type 2 diabetes.

“…On a broader scale, a history of trauma is also associated with distrust in healthcare systems (Klest et al, 2019). Given that negative interpersonal interactions with healthcare personnel are associated with non-attendance at diabetes outpatient appointments (Sun et al, 2021), improving the quality of interactions between patients, providers, medical staff, and healthcare administrators should remain a priority. Moreover, the quality of patients' routine care experiences beyond the exam room warrants attention, including checking of vital signs and current medication list review, check-in and interactions with office reception, appointment reminders, waiting room signage, verbiage on pre-visit screening questionnaires, website and social media messaging, referral process, and prescription refill reminders.…”