title: Missed Medical Appointments and Disease Control in Children With Type 1 Diabetes.
abstract: The need exists to identify children with type 1 diabetes who are at risk for poor outcomes, and we hypothesized that missed appointments could be a useful indicator. We aimed to describe the frequency of missed medical appointments in children with type 1 diabetes and evaluate the relationship between missed appointments and poor disease control. Medical records of 1,002 children aged 0-17 years with type 1 diabetes and two or more scheduled appointments during a 43-month period were reviewed. Sixty-eight percent of patients missed no appointments, 17% missed one appointment, and 15% missed two or more appointments. Compared with patients who missed no appointments, patients who missed two or more appointments were three times more likely to have a diabetic ketoacidosis episode and three times more likely to have a hemoglobin A1c level equal to or greater than 8.5%. They were also more likely to be a member of a racial/ethnic minority group and be publicly insured. Missed appointments may be an important indicator of poor treatment adherence, requiring targeted interventions.
authors.forename: Kristine
authors.initials: K
authors.lastname: Fortin
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Pries
authors.forename: Soyang
authors.initials: S
authors.lastname: Kwon
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001071:Appointments and Schedules; D002641:Chicago / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D016883:Diabetic Ketoacidosis / Q000453:epidemiology* / Q000517:prevention & control; D037001:Directive Counseling; D005006:Ethnicity; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects*; D019538:Health Care Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007223:Infant; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D012923:Social Class; D016903:Drug Monitoring
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Adherence; medical care; medical neglect; outcomes; type 1 diabetes mellitus