Highlights
- •Missed appointments may cause disruptions in MS-related care.
- •Cancellations tend to occur due to situational factors, such as weather.
- •Issues with prospective memory and emotional distress are related to no shows.
- •Creating targeted interventions may help reduce non-attendance.
Abstract
Background
There has yet to be an examination of how appointment attendance behaviors in multiple
sclerosis (MS) are related to scheduling metrics and certain demographic, clinical,
and behavioral factors such as cognitive functioning and personality traits. This
study aimed to examine the factors that differ between no shows (NS), short notice
cancellations (SNC), and attended appointments.
Methods
Participants (n = 110) were persons with MS who were enrolled in a larger cross-sectional study,
during which they completed a battery of neuropsychological measures. Data about their
appointments in three MS-related clinics the year prior to their study evaluation
were extracted from the medical record. Bivariate analyses were done, with post-hoc
tests conducted with Bonferroni corrections if there was an overall group difference.
Results
A higher number of SNC were noted during the winter, with 22.4% being due to the weather.
SNC were also more common on Thursdays, but less frequent during the early morning
time slots (7am to 9am). In contrast, NS were associated with lower annual income,
weaker healthcare provider relationships, lower self-efficacy, higher levels of neuroticism,
depressive symptom severity, and health distress, and greater cognitive difficulties,
particularly with prospective memory.
Conclusions
While SNC are related to clinic structure and situational factors like the weather,
NS may be more influenced by behavioral issues, such as difficulty remembering an
appointment and high levels of distress. These findings highlight potential targets
for reducing the number of missed appointments in the clinic, providing opportunities
for improved healthcare efficiency and most importantly health.
Keywords
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References
- Reducing missed appointments for patients with HIV: an evidence-based approach.J. Nurs. Care Qual. 2020; 35: 165-170
- Patients’ reasons for missing scheduled clinic appointments and their solutions at a major urban-based academic medical center.J. Community Hosp. Intern. Med. Perspect. 2020; 10: 426-430
- Multiple regression approach to analyzing contingency tables: post hoc and planned comparison procedures.J. Exp. Educ. 1995; 64: 79-93
- Sociobehavioral determinants of compliance with health and medical care recommendations.Med. Care. 1975; 13: 10-24
- The multiple sclerosis self-management scale: revision and psychometric analysis.Rehabil. Psychol. 2011; 56: 150
- A profile of patients who fail to keep appointments in a veterans affairs primary care clinic.WMJ. 2016; 115: 185-190
- Reducing missed psychotherapy appointments: an advanced practice nurse-initiated telephone orientation protocol.Perspect. Psychiatr. Care. 2022; 58: 2756-2763
- Treatment adherence in multiple sclerosis: association with emotional status, personality, and cognition.J. Behav. Med. 2010; 33: 219-227
- Behaviourally informed, patient-led interventions to reduce missed appointments in general practice: a 12-month implementation study.Fam. Pract. 2022;
- Treating learning impairments improves memory performance in multiple sclerosis: a randomized clinical trial.Mult. Scler. J. 2005; 11: 58-68
- An RCT to treat learning impairment in multiple sclerosis: the MEMREHAB trial.Neurology. 2013; 81: 2066-2072
- The efficacy of the modified story memory technique in progressive MS.Mult. Scler. J. 2020; 26: 354-362
- Barriers to the accessibility and continuity of health-care services in people with multiple sclerosis: a literature review.Int. J. MS Care. 2017; 19: 313-321
Costa, P., McCrae, R.R., 2010. The NEO personality inventory: 3. Odessa, FL: psychological assessment resources.
- Interventions to increase appointment attendance in safety net health centers: a systematic review and meta-analysis.J. Eval. Clin. Pract. 2021; 27: 965-975
- No-shows in appointment scheduling–a systematic literature review.Health Policy. 2018; 122 (New York): 412-421
- Integrated telerehabilitation approach in multiple sclerosis: a systematic review and meta-analysis.J. Telemed. Telecare. 2020; 26: 385-399
- Mood disorders in multiple sclerosis and the effects on cognition.J. Neurol. Sci. 2006; 245: 63-66
- Risk factors for suboptimal medication adherence in persons with multiple sclerosis: development of an electronic health record-based explanatory model for disease-modifying therapy use.Arch. Phys. Med. Rehabil. 2020; 101: 807-814
- Who is not coming to clinic? A predictive model of excessive missed appointments in persons with multiple sclerosis.Mult. Scler. Relat. Disord. 2020; 103: 915-920
- What biopsychosocial factors explain self-management behaviors in multiple sclerosis? The role of demographics, cognition, personality, and psychosocial and physical functioning.Arch. Phys. Med. Rehabil. 2021; 102: 1982-1988
- Demographic and clinical factors are associated with frequent short-notice cancellations in veterans with multiple sclerosis on disease modifying therapies.Arch. Phys. Med. Rehabil. 2021;
- What factors are associated with resilience in persons with multiple sclerosis? The role of personality traits.Rehabil. Psychol. 2022; 102: 1982-1988
- Adherence to medical appointments among patients undergoing bariatric surgery: do health literacy, health numeracy, and cognitive functioning play a role?.Obes. Surg. 2022; 32: 1391-1393
- Disease steps in multiple sclerosis a simple approach to evaluate disease progression.Neurology. 1995; 45: 251-255
- Disease steps in multiple sclerosis: a longitudinal study comparing disease steps and EDSS to evaluate disease progression.Mult. Scler. J. 1999; 5: 349-354
- Validation of the hospital anxiety and depression scale for use with multiple sclerosis patients.Mult. Scler. J. 2009; 15: 1518-1524
- No-show to primary care appointments: why patients do not come.J. Prim. Care Community Health. 2013; 4: 251-255
- Prospective memory and the efficacy of a memory strategy in multiple sclerosis.Neuropsychology. 2008; 22: 746
- Why we don't come: patient perceptions on no-shows.Ann. Fam. Med. 2004; 2: 541-545
- Validation of patient determined disease steps (PDDS) scale scores in persons with multiple sclerosis.BMC Neurol. 2013; 13: 37
- Self-management education: history, definition, outcomes, and mechanisms.Ann. Behav. Med. 2003; 26: 1-7
- Validity of performance scales for disability assessment in multiple sclerosis.Mult. Scler. J. 2007; 13: 1176-1182
- General health issues in multiple sclerosis: comorbidities, secondary conditions, and health behaviors.Continuum. 2013; 19 (Minneap Minn)Multiple Sclerosis: 1046-1057
- Expanded access to multiple sclerosis teleneurology care following the COVID-19 pandemic.Mult. Scler. J. Exp. Transl. Clin. 2021; 72055217321997467
- Why don't patients attend their appointments? Maintaining engagement with psychiatric services.Adv. Psychiatr. Treat. 2007; 13: 423-434
- Time and money: effects of no-shows at a family practice residency clinic.Fam. Med. 2001; 33 (Kansas City-): 522-527
- Zip code distance database. 2023
- Reasons for and consequences of missed appointments in general practice in the UK: questionnaire survey and prospective review of medical records.BMC Fam. Pract. 2005; 6: 47
Nguyen, C., Raskin, S.A., Turner, A.P., Dhari, Z., Neto, L.O., Gromisch, E.S., 2022. Characterizing prospective memory errors and their neuropsychological correlations in persons with MS, Proceedings of the Consortium of Multiple Sclerosis Centers' Annual Meeting National Harbor, MD.
- An empirical investigation into factors affecting patient cancellations and no-shows at outpatient clinics.Decis. Support Syst. 2014; 57: 428-443
- Factors associated with appointment non-adherence among African-Americans with severe, poorly controlled hypertension.PLoS One. 2014; 9e103090
- A Meta-analysis of the effect of motivational interviewing on depression, anxiety, and quality of life in stroke patients.J. Neurosci. Nurs. 2021; 53: 244-250
Raskin, S.A., Buckheit, C., Sherrod, C., 2010. Memory for intentions screening test: manual. Psychological Assessment Resources, Inc., Lutz, FL.
- Prospective memory intervention using visual imagery in individuals with brain injury.Neuropsychol. Rehabil. 2019; 29: 289-304
- Multiple Sclerosis Quality of Life Inventory: A User's Manual.National MS Society, New York2015
Smith, A., 1982. Symbol digit modalities test: manual. Western psychological services, Los Angeles, CA.
- Compendium of Neuropsychological tests: Administration, norms, and Commentary.Oxford University Press, New York, NY2006
- Telephone counseling and home telehealth monitoring to improve medication adherence: results of a pilot trial among individuals with multiple sclerosis.Rehabil. Psychol. 2014; 59: 136
University of Washington Self-Efficacy Scale (UW-SES) Version 1 Users Guide. https://uwcorr.washington.edu/wp-content/uploads/2018/12/uw-ses-userguide.pdf. (Accessed April 22 2019,).
- Why do TRICARE beneficiaries miss medical appointments?.Math. Policy Res. 2018;
- Psychological characteristics of frequent short-notice cancellers of diabetes medical and education appointments.Diabetes Care. 2005; 28: 1791-1793
- Impact of demographics and appointment characteristics on patient attendance in a university dental clinic.J. Dent. Educ. 2021; 85: 615-622
- The hospital anxiety and depression scale.Acta Psychiatr. Scand. 1983; 67: 361-370
- The role of prospective memory in medication adherence: a review of an emerging literature.J. Behav. Med. 2012; 35: 47-62
Article info
Publication history
Published online: January 06, 2023
Accepted:
January 5,
2023
Received in revised form:
December 28,
2022
Received:
September 30,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
