A Comparative Survey of Missed Initial and Follow-Up Appointments to Psychiatric Specialties in the United Kingdom

Department of Liaison Psychiatry, Leicester General Hospital, UK.
Psychiatric Services (Impact Factor: 2.41). 07/2007; 58(6):868-71. DOI: 10.1176/
Source: PubMed


Missed appointments are common in psychiatry. Nonattendance at the initial appointment may have different prognostic significance than nonattendance at subsequent appointments. This study examined the frequency of missed appointments among 9,511 initial outpatient appointments and 7,700 follow-up appointments across ten psychiatric subspecialties in a publicly funded mental health service in the United Kingdom.
The pooled missed appointment rate was 15.9%, higher than in previous studies on primary and secondary care attendance in the United Kingdom. Nonattendance was lowest on Fridays, in winter months, and in geriatric psychiatry and highest for substance abuse services and in community psychiatry. In most services, attendance improved after the initial appointment, but in psychosomatic medicine and geriatric psychiatry this pattern was reversed.
There was a low rate of missed appointments in geriatric psychiatry, rehabilitation psychiatry, cognitive-behavioral therapy, and psychosocial medicine. A high nonattendance rate was found among persons with drug and alcohol difficulties and to a lesser extent in general adult psychiatry. Future studies should consider initial and follow-up appointments as distinct.

  • Source
    • "Missed patient appointments at university psychiatry clinics have been a major source of financial concern given the wasted time of faculty and resources (Peters & Bayer, 1999). There has been a plethora of recent studies that recommend ways to increase appointment attendance (Basem & Alapont, 1993; Cruz et al., 2013; Killaspy, Banerjee, King, & Lloyd, 2000; Lister & Scott, 1988; McNeil, Gormley, & Binder, 2013; Mitchell & Selmes, 2007a, 2007b; Murphy, Mansell, & Craven, 2014; Paige & Mansell, 2013; Paolilio & Moore, 1984; Peters & Bayer, 1999; Shoffner, Staudt, Marcus, & Kapp, 2007; Sims, Sanghara, Hayes, Wandiembe, & Finch, 2012; Sparr et al., "
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective was to test an intervention to reduce failed rates for psychiatric appointments. We collected data for this study of the characteristics of patients who missed appointments from March 2011 through September 2012. A phone triage assessment intervention was implemented to address chronic first-time failed attendance appointments (N = 78). The main reason for failed appointments was transportation difficulties. The first-time appointment show rate increased after implementing an assessment intervention. Phone assessment intervention was practical and may improve nonattendance for psychiatric appointments. The discussion reflects speculations about causes and possible measures to make services more accessible.
    Preview · Article · Jan 2016 · SAGE Open
  • Source
    • "Therefore it may be speculated that prior physiatrists referred the cases who already have attended the clinical visits regularly. Various factors including an ethnic minority, lower socioeconomic status, lack of health insurance, low educational status, unemployment, single, a personality disorder or a substance use disorder have been associated with dropout (Mitchell and Selmes, 2007; Olfson et al., 2009). Additionally, not taking psychotropic medications, younger age and poor family support have been causative factors for nonattendance (Kruse et al., 2002). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Dropout is a common problem in the treatment of psychiatric illnesses including bipolar disorders (BD). The aim of the present study is to investigate illness perceptions of dropout patients with BD. A cross sectional study was done on the participants who attended the Mood Disorder Outpatient Clinic at least 3 times from January 2003 through June 2008, and then failed to attend clinic till to the last one year, 2009, determined as dropout. Thirty-nine dropout patients and 39 attendent patients with BD were recruited for this study. A sociodemographic form and brief illness perception questionnaire were used to capture data. The main reasons of patients with BD for dropout were difficulties of transport (31%), to visit another doctor (26%), giving up drugs (13%) and low education level (59%) is significant for dropout patients. The dropout patients reported that their illness did not critically influence their lives, their treatment had failed to control their illnesses, they had no symptoms, and that their illness did not emotionally affect them. In conclusion, the nonattendance of patients with serious mental illness can result in non-compliance of therapeutic drug regimens, and a recurrence of the appearance symptoms. The perception of illness in dropout patients with BD may be important for understanding and preventing nonattendance. Copyright © 2015 Elsevier B.V. All rights reserved.
    Full-text · Article · Apr 2015 · Asian Journal of Psychiatry
  • Source
    • "social media sites and snowball techniques (Liamputtong, 2013). As reported by Mitchell and Selmes (2007), women with mental health disorders have often been reluctant to seek help for iatrogenic sexual problems; therefore, we did not recruit through health professionals or clinics. Women were screened using a brief emailed questionnaire to ensure inclusion criteria were met and to attempt to identify factors other than SSRIs, such as a recent illness or addition of a new medication, which may Psychology & Health 3 have impacted on sexual difficulties . "
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract A growing body of evidence has highlighted the sexual side effects of selective serotonin reuptake inhibitor (SSRI) medication. Whilst most of the research has focused on the prevalence and treatment of sexual difficulties, little is known about how patients cope with the SSRI related sexual side effects. The objective of this study was to explore women's experiences of coping with the sexual side effects of SSRI medication and interpretative phenomenological analysis (IPA) was employed for an in-depth exploratory study of a sample of ten women. Four broad themes emerged which are discussed under the following headings: searching, suffering in silence, trying to resolve and accepting what is. The themes provide an insight into the different strategies used by women to cope with the sexual side effects of SSRI medication and highlight the importance of contextualising these difficulties as part of an overall approach to improve the management and treatment of SSRI related sexual side effects.
    Full-text · Article · Jul 2014 · Psychology and Health
Show more