Appointment attendance predicts level of glycaemic control in people with diabetes

Abstract

Question

Do people who miss scheduled healthcare appointments have poorer management of their diabetes?

Study design

Retrospective cross-sectional cohort study.

Main results

During the year 2000, 12% of participants missed >30% of scheduled appointments, 52% missed 1–30% and 35% missed none. Glycaemic control was poorer in those who missed most appointments (p<0.0001), irrespective of how diabetes was controlled (diet, oral agent or insulin). The adjusted mean glycosylated haemoglobin level (HbA_1c) was higher in people attending appointments compared with people missing >30% of appointments (p<0.0001). Daily self-monitoring was associated with a fewer missed appointments (OR 1.8, 95% CI 1.7 to 1.9). People with inadequate medication ⩾20% of the time were more likely to miss appointments (OR 1.5, p<0.0001). Living in a poverty area, pharmacologic control of diabetes, use of antidepressants and having fewer scheduled appointments were significantly associated with missing >30% of scheduled appointments.

Authors’ conclusions

People with diabetes who frequently miss appointments are likely to have poorer glycaemic control and less frequent self-monitoring. Level of attendance could be monitored and used for clinical risk stratification.