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Palliative medicine outpatient clinic ‘no-shows’: retrospective review
  1. Mirza Jacqueline Alcalde Castro1,
  2. Ashley Pope1,
  3. Yuhua Zhang2,
  4. Ahmed Al-Awamer1,
  5. Subrata Banerjee1,
  6. Jenny Lau1,
  7. Ernie Mak1,
  8. Brenda O'Connor1,
  9. Alexandra Saltman1,3,
  10. Kirsten Wentlandt4,
  11. Camilla Zimmermann1 and
  12. Breffni Hannon1
  1. 1Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
  2. 2Biostatistics, University Health Network, Toronto, Ontario, Canada
  3. 3Medicine, Rheumatology, Sinai Health System, Toronto, Ontario, Canada
  4. 4Supportive Care, Toronto General Hospital, Toronto, Ontario, Canada
  1. Correspondence to Dr Breffni Hannon, Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; breffni.hannon{at}uhn.ca

Abstract

Objectives Patients who do not attend outpatient palliative care clinic appointments (‘no-shows’) may have unmet needs and can impact wait times. We aimed to describe the characteristics and outcomes associated with no-shows.

Methods We retrospectively reviewed new no-show referrals to the Princess Margaret Cancer Centre Oncology Palliative Care Clinic (OPCC) in Toronto, Canada, between January 2017 and December 2018, compared with a random selection of patients who attended their first appointment, in a 1:2 ratio. We collected patient information, symptoms, performance status (Eastern Cooperative Oncology Group (ECOG) and outcomes. Univariable and multivariable logistic regression analyses were used to identify significant factors.

Results Compared with those who attended (n=214), no-shows (n=103), on multivariable analysis, were at higher odds than those who attended of being younger (OR 0.98, 95% CI 0.96 to 1.00, p=0.019), living outside Toronto (OR 2.67, 95% CI 1.54 to 4.62, p<0.001) and having ECOG ≥2 (OR 2.98, 95% CI 1.41 to 6.29, p=0.004). No-shows had a shorter median survival compared with those who attended their first appointment (2.3 vs 8.7 months, p<0.001).

Conclusion Compared with patients who attended, no-shows lived further from the OPCC, were younger, and had a poorer ECOG. Strategies such as virtual visits should be explored to reduce no-shows and enable attendance at OPCCs.

  • other cancer
  • clinical assessment
  • quality of life
  • supportive care

https://doi.org/10.1136/bmjspcare-2021-003414

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    Footnotes

    • Twitter @JelauPC

    • Contributors MJAC, AP, BH contributed to study design and data extraction. YZ contributed to statistical analyses. MJAC, CZ, BH contributed to manuscript writing. AA-A, SB, JL, EM, BO’C, AS, KW contributed to manuscript revision. BH contributed to overall responsibility for the study.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.