Factors associated with clinic nonattendance in adults with Type 1 diabetes mellitus

In order to examine the causes of non-attendance in a diabetic clinic, a 1-year retrospective casenote review of 259 diabetic patients with no evidence of major complications was undertaken. Frequency of clinic attendance, clinic non-attendance, and glycaemic control (HbA1c) were recorded. In a sub-sample of 82 patients, more detailed demographic data was obtained via questionnaire. During the previous year 39 % of patients had failed to attend the clinic on at least one occasion and 10 % were recurrent non-attenders. Nonattenders had a significantly higher mean HbA(1c) compared with those who did attend (8.1 +/- 2.2 vs 7.6 +/- 1.6 %; p = 0.03). They were also significantly younger (mean age 27 +/- 7 vs 29 +/- 9 yrs; p = 0.02) and had a significantly shorter duration of diabetes (12 +/- 8 vs 15 +/- 10 yrs; p = 0.02). Attendance did not differ according to gender or age of onset of diabetes. Sub-sample analysis showed that smokers, those with children at home, and single parents were all more likely to default from their appointments. Non-attendance is a significant problem at our diabetic clinic, however, by addressing the reasons why patients fail to attend clinic we hope to develop strategies to encourage regular attendance. This may be translated into improved glycaemic control and ultimately reduce the risk of late diabetic complications. (C) 1998 John Wiley & Sons, Ltd.