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- Title
(MOC02) Cancelling Clinic Appointments: What Factors Are Associated with Higher Rates of Cancellations in Patients with Multiple Sclerosis?
- Authors
Gromisch, Elizabeth S.; Turner, Aaron P.; Leipertz, Steven L.; Beauvais, John; Haselkorn, Jodie K.
- Abstract
Background: It is important that persons with multiple sclerosis (MS) attend their scheduled appointments to maintain continuity of care and promote successful self-management. A recent study examined missed appointments in veterans with MS and developed a model that included 7 predictor variables (suboptimal disease-modifying therapy [DMT] adherence (>80%), emergency visits, age, distance, and histories of post-traumatic stress disorder, chronic obstructive pulmonary disease, and congestive heart failure). However, to date, there is limited information on appointment cancellations, which is a different appointment attendance behavior but can also disrupt care. Objectives: 1) To identify the rate of cancelled appointments in a large national sample of persons with MS and 2) to examine the demographic and clinical factors associated with high levels of cancelled appointments (defined as ≥50th percentile). Methods: Administrative data between January 1, 2013, and December 31, 2015, were extracted from the VA MS Center of Excellence Data Repository, an electronic health record--based dataset composed of US veterans receiving services at any Veterans Affairs (VA) medical center. The cancellation rate was calculated by dividing the number of cancelled appointments (excluding "no shows") by the total number of scheduled appointments during this 2-year timeframe. Bivariate analyses were conducted to examine demographic and clinical characteristic differences between individuals with and without high rates of cancellations, and variables with a P value of <.10 were entered into a logistic regression. Results: Over 96% (n = 3623) had at least 1 cancelled appointment, with a median cancellation rate of 25%. Flags for high rates of cancellations included 1 or more inpatient hospitalization (odds ratio [OR]: 1.78), wheelchair issuance (OR: 1.48), distance (≥24.1 miles away; OR: 1.47), gender (male; OR: 1.28), suboptimal DMT adherence (OR: 1.26), and history of a mood disorder (OR: 1.28). Conclusions: Cancelled appointments are prevalent among veterans with MS. The similarities and differences in the variables included in the cancelled and missed appointment models highlight both malleable and nonmalleable factors associated with each type of appointment attendance behavior. While further information is needed to elucidate the reasons behind these cancelled appointments, these results may help clinicians identify individu
- Subjects
CONFERENCES &; conventions; MEDICAL appointments; MULTIPLE sclerosis; PATIENT compliance
- Publication
International Journal of MS Care, 2020, Vol 22, Issue S2, p51
- ISSN
1537-2073
- Publication type
Article