Cancellation of outpatient appointments in patients with attention-deficit/hyperactivity disorder

Nomura, Kensuke and Tarumi, Ryosuke and Yoshida, Kazunari and Sado, Mitsuhiro and Suzuki, Takefumi and Mimura, Masaru and Uchida, Hiroyuki and Ikeda, Kazutaka (2021) Cancellation of outpatient appointments in patients with attention-deficit/hyperactivity disorder. PLOS ONE, 16 (11). e0260431. ISSN 1932-6203

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Abstract

Background
Regular visit to psychiatric clinic is essential for successful treatment of any psychiatric condition including attention-deficit/hyperactivity disorder (AD/HD). However, cancellation of outpatient appointments in patients with AD/HD, which represents a significant medical loss, has not been systematically investigated to our knowledge.

Methods
A systematic chart review was conducted for patients visiting the Shimada Ryoiku medical Center for Challenged Children in Japan at the age of ≤15 years from January to December 2013. The primary outcome measure was the cancellation rate, defined as the number of missed visits divided by the number of scheduled visits. The cancellation rates during 24 months after the first visit were compared between outpatients with AD/HD and other psychiatric disorders, including pervasive developmental disorders (PDD), and developmental coordination disorders and/or communication disorders (DCD-CD). A generalized linear model with binomial distribution was used to examine factors associated with cancellation rates exclusively in the AD/HD group.

Results
We included 589 patients (mean ± SD age, 5.6 ± 3.4 years; 432 males) in the analysis. The cancellation rate in patients with AD/HD was 12.3% (95% confidence interval [CI]: 10.0–15.1), which was significantly higher than in those with PDD (5.6%, 95% CI: 3.8–8.3) and DCD-CD (5.3%, 95% CI: 3.6–7.8). Prescriptions of osmotic-release oral system-methylphenidate (OROS-MPH) and antipsychotics were associated with fewer cancellations in AD/HD patients (odds ratios: 0.61, 95% CI: 0.39–0.95 and 0.49, 95% CI: 0.25–0.95, respectively), although these significances did not find in the subgroup analysis including only patients with ≥ 6 years old.

Conclusions
Patients with AD/HD were more likely to miss appointments compared to those with other psychiatric disorders. The impact of AD/HD medications as well as potential psychiatric symptoms of their parents or caregivers on appointment cancellations needs to be evaluated in more detail in future investigations.

Item Type: Article
Subjects: Impact Archive > Medical Science
Depositing User: Managing Editor
Date Deposited: 23 Feb 2023 06:19
Last Modified: 02 Mar 2024 04:18
URI: http://research.sdpublishers.net/id/eprint/967

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