15 January 2019

Missing GP appointments linked to mortality risk

General Practice Mental Health Research

Patients with long-term conditions who miss primary healthcare appointments are at higher risk of premature death than those who diligently attend their GPs, a British study has found.

The study is the first to compare the correlation of mortality rates of patients with long-term physical and mental conditions with how frequently they visit their GP and actually show up for appointments.

“Patients with a greater number of long-term conditions had an increased risk of missing general practice appointments despite controlling for number of appointments made,” the authors, writing in BMC Medicine, said.

The study examined the appointments and attendance of more than 800,000 patients and 11 million appointments across Scottish general practices for three years.

In particular, the most at-risk group was patients with long-term mental health conditions who missed more than two appointments per year.

This cohort had a greater than eight-fold increase in risk of all-cause mortality compared with those who missed no appointments, the authors said.

“These patients died prematurely, commonly from non-natural external factors such as suicide.

“For these patients, existing primary healthcare appointment systems are ineffective,” the authors said.

Even patients who missed just one or two appointments a year had a mortality rate twice as high as those who never missed an appointment.

The authors suggested Britain’s National Health Service should consider more effective options to engage patients in keeping regular GP visits.

For example, people who presented with long-term mental health issues could be offered on-the-day appointments, the authors suggested.