The reason and impact of missed psychiatric appointment

Abstract

Objective To study missed appointment rate, the reason for missed appointment, and impact of missed appointment in psychiatric outpatients.

Materials and methods Medical records of psychiatric patients who were appointed from April 2009 to September 2009 at the outpatient clinic at Galya Rajanagarindra Institute, were reviewed
retrospectively for 1 year. Data were analysed by using descriptive statistics.

Results Of the 365 patients whose medical records were reviewed, 21.4% missed their appointments. Of these, 54.2% visited the clinic earlier than appointed dates, while 45.8% came later.
Psychiatric symptom exacerbation, adverse drug reactions, and inadequate amount of medicine were the reasons for coming earlier in 43.6%, 15.4% and 13.1% of the patients, respectively. While the reasons
of visiting later than the appointments were psychiatric symptom exacerbation, problems in business, communication system, or economic status, and remained amount of medicine in 23.0%, 13.4% and
10.4% respectively. Patient’s characteristics, i.e. sex, age, marital status, educational level, dwelling, type of medical welfare and diagnosis were not associate with missed appointment. However, patients with
missed appointments had signifi cantly higher rates of psychiatric emergency and hospital admissions than followed-appointment patients.

Conclusion Approximately one-fi fth of the psychiatric patients missed their appointments. The most common reason for missed appointments was psychiatric symptom exacerbation. In addition, missed
appointment patients had signifi cantly higher rate of psychiatric emergency and hospital admission than followed appointment patients. Hence, monitoring for psychiatric symptoms exacerbations and adverse
drug reaction are important. Psychiatrists should check each patient’s reason for missed appointments to plan appropriate, individualized treatment strategy and frequency of psychiatric appointments.