title: A comparative survey of missed initial and follow-up appointments to psychiatric specialties in the United kingdom.
abstract: OBJECTIVE
  Missed appointments are common in psychiatry. Nonattendance at the initial appointment may have different prognostic significance than nonattendance at subsequent appointments. This study examined the frequency of missed appointments among 9,511 initial outpatient appointments and 7,700 follow-up appointments across ten psychiatric subspecialties in a publicly funded mental health service in the United Kingdom.
  
  
  RESULTS
  The pooled missed appointment rate was 15.9%, higher than in previous studies on primary and secondary care attendance in the United Kingdom. Nonattendance was lowest on Fridays, in winter months, and in geriatric psychiatry and highest for substance abuse services and in community psychiatry. In most services, attendance improved after the initial appointment, but in psychosomatic medicine and geriatric psychiatry this pattern was reversed.
  
  
  CONCLUSIONS
  There was a low rate of missed appointments in geriatric psychiatry, rehabilitation psychiatry, cognitive-behavioral therapy, and psychosocial medicine. A high nonattendance rate was found among persons with drug and alcohol difficulties and to a lesser extent in general adult psychiatry. Future studies should consider initial and follow-up appointments as distinct.
authors.affiliation: Department of Liaison Psychiatry, Leicester General Hospital, UK. alex.mitchell@leicspart.nhs.uk
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Mitchell
authors.forename: Thomas
authors.initials: T
authors.lastname: Selmes
mesh_terms: D001071:Appointments and Schedules; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D001523:Mental Disorders / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011570:Psychiatry / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D013038:Specialization / Q000706:statistics & numerical data; D013222:State Medicine / Q000706:statistics & numerical data*; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000453:epidemiology; D016312:Treatment Refusal / Q000706:statistics & numerical data*; D006113:United Kingdom; D014600:Utilization Review / Q000706:statistics & numerical data