Endocrine Abstracts (2011) 27 P67

Clinic appointment reminders and their effect on 'did not attend' (DNA) rates and HbA1C, in a paediatric diabetes clinic

Pooja Sachdev1, Elaine Gunn2, Katie Harron3 & Anuja Natarajan2

1Sheffield Children’s Hospital NHS Foundation Trust, Sheffield, UK; 2Doncaster and Bassetlaw NHS Foundation Trust, Doncaster, UK; 3Institute of Child Health, Centre for Paediatric Epidemiology and Biostatistics, University College, London, UK.

Background: Non-attendance in outpatient clinics results in administrative problems, economic loss and poor patient care. Mobile phone intervention has been shown to be effective in improving attendance rates in chronic disease follow up. A pilot study conducted over 9 months in our diabetes clinic showed improved attendance following phone calls and text messages sent to carers/young people prior to their clinic appointment (statistical significance reached when patient spoken to, P<0.05).

Aims: (1) To analyse DNA rates when carers/patients were telephoned or texted prior to their clinic appointment over a 2-year period.

(2) Did the change in attendance result in improved HBA1c’s?

Methods: Prospective 2 year study with the 1st 8 months serving as control (routine hospital appointments made by patient) followed by an 8-month period of calling carers/patients to remind them of their appointment and the third period of 8 months of text messaging reminders. Paired t-testing was used to compare DNA rates in the control and intervention period. The overall control of the clinic as reflected by average HBA1c and HBA1c at end of each period (control/phone/text messaging) was also compared.

Results: Data for 104 patients available. The proportion of clinics not attended decreased over the time period, though not statistically significant. (P<0.45). HbA1c and average HbA1c increased over the study period.

Conclusion: Our preliminary results do not support the findings of other studies which show a significant improvement in attendance following use of telephone or text message reminders, though notably, most of these have been over shorter periods of time. Sub analysis within our telephone and text messaging subsets is underway and may reveal better ways of improving clinic attendance. This study clearly identifies the need for scarce NHS resources to be directed appropriately at measures that are sustainable over longer periods and translate into improved patient outcomes.

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