Patients with attention deficit hyperactivity disorder (ADHD) are 60-90% more likely to miss GP appointments compared with the general population, research suggests.
In the first study to look at the issue of multiple missed doctors appointments in people with the condition, researchers analysed data from 136 GP practices in Scotland.
Among 2453 patients with a diagnosis of ADHD and more than 12,200 age and sex matched controls, researchers reported in PLOS Mental Health that there was a significant different in the proportion of missed appointments.
For children and adolescents with recorded ADHD, 21% missed at least one face to face appointment a year, compared with 10% of people without the condition. Around 8% of the under 18 group with ADHD missed two or more appointments annually.
In adults, missing appointments was more common with 38% of those with ADHD not attending one appointment a year compared with 23% of controls. In this group 16% of those with ADHD missed two or more.
The researchers did note that in this group of Scottish patients with records reviewed from 2013 to 2016, the recorded prevalence of ADHD was 0.3% – a lower prevalence than the 2-5% that would be expected. In all, 84% of recorded diagnoses in patients under 35 years old.
Their findings raise ‘significant concern’ for patient care and have direct implications for general practice, including on identifying ways to help people engage with healthcare services, the researchers said.
Previous research by the same team has shown that missing appointments is linked to a greatly increased risk of illness and early death.
A report earlier this year from the Nuffield Trust warned that demand for autism and ADHD assessments is increasing at such a rate that they have surpassed the ability of the NHS to keep up.
Professor David Ellis, from the University of Bath’s School of Management, said: ‘Missed appointments can have short and long-term consequences for society as a whole, but crucially we know multiple misses are a red flag for poor patient outcomes.
‘It can mean missed opportunities for providing care where it is often most needed.
He added: ‘Our study showed patients with ADHD have higher rates of both mental and physical health problems than those without the condition, so multiple missed appointments will take their toll. Missing appointments may also be playing a role in delayed diagnosis and treatment of ADHD.’
Co-author Professor Andrea Williamson, from the University of Glasgow, said: ‘We often hear criticism of people who miss GP appointments, but patients with ADHD may struggle to attend due to cognitive impairments associated with their condition.
‘These impairments can affect their ability to schedule and remember appointments. Understanding and addressing ‘missingness’ is a complex issue that requires research and targeted interventions in health care to improve outcomes.’
