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GPs go forth

Patients who repeatedly miss GP appointments more likely to die

Patients who repeatedly miss GP appointments are at greater risk of death from all causes, and those with mental health conditions are particularly affected, a study has found.

The observational research, published by BMC Medicine, drew on appointment data from 136 general practices in Scotland, analysing 11.5m appointments from over 8m patients.

The researchers, from the Universities of Glasgow, Aberdeen and Lancaster, linked the dataset to the Scottish death registry to assess the impact on mortality.

The paper concluded that those who missed appointments had an increased risk of dying during the following year.

Patients with long-term mental health conditions were worst impacted. Those who missed multiple appointments were eight times as likely to die as those who missed none.

Patients with physical health conditions who missed appointments were three times as likely to die in the following year as those who attended all appointments.

But researchers also found that having a long-term health condition of any kind correlated with a higher risk of missing consultations in the first place.

They found:

  • Mental health diagnoses meant patients were up to 50% more likely to miss appointments than those with no diagnosed condition.
  • Patients with physical health conditions were as much as 38% more likely to miss consultations than those with no health problems.

The study said: ‘Missed appointments represent a significant risk marker for all-cause mortality, particularly in patients with mental health conditions’.

But researchers suggested that a directly causal relationship between missed appointments and death is unlikely.

The paper concluded that for vulnerable patients ‘existing primary healthcare appointment systems are ineffective’ and said that ‘interventions should be developed with a particular focus on increasing attendance by these patients’.

RCGP chair Professor Helen Stokes-Lampard said: 'People miss appointments for a range of reasons, but this study highlights why it’s more important to show compassion to people who fail to attend, rather than punishing them - for some, life gets in the way and they forget, but others might not turn up precisely because of their health issue.

'As this research has demonstrated, this particularly applies to patients with mental health conditions.'

Readers' comments (4)

  • Most of my surgeries are between 16-20 patients. If one or two don't attend I'm afraid there is not a lot of hand-wringing on my part.

    The ones who turn up late cause me a greater problem.

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  • DNAs mean GP less likely to die

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  • Patient receives text when booking an appointment:
    Mrs Smith, an appointment has been booked with Dr Jones for 10.00 on 15th January. Please cancel if you cannot attend or you will die.

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  • David Banner

    Not attending is a choice, admittedly a bad choice, but a choice nonetheless. It is the responsibility of the patient, not the GP. Don’t even think of trying to palm the blame on to doctors, we’re busy enough dealing with those with the decency to actually attend. This is still a democracy, people have the right to be wrong.

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