Non‐attendance in chronic disease clinics: a matter of non‐compliance?

paterson bl, charlton p & richard s (2010) Journal of Nursing and Healthcare of Chronic Illness2, 63–74 Non-attendance in chronic disease clinics: a matter of non-compliance? Aim.  To identify the personal, contextual and mediating factors that influence non-attendance in specialty chronic disease clinics. Background.  Non-attendance in chronic disease clinics is an ongoing problem that can increase patients’ vulnerability to serious complications, affect continuity of care, contribute to long wait times, engender negative patient–provider relationships, and increase costs to the health system. Methods.  Literature for this review was obtained by an extensive search of health and social science computerised bibliographic databases using the search terms participation, attendance, non-attendance, attrition, dropout, missed appointment, no show with diabetes, chronic disease and chronic illness care. Results.  Twenty-eight research studies met our criteria for inclusion in the review. Analyses revealed that non-attendance at chronic disease clinics is influenced by a myriad of factors encompassed as personal and clinical factors, and factors pertaining to the nature and operations of the clinic. Conclusions.  The factors that influence attendance are complex and multifactoral. A range of strategies are needed to address the myriad of patient-related and health-system factors to increase attendance rates and ultimately improve health outcomes. Relevance to clinical practice.  A critical analysis of factors that affect attendance is important to begin to develop a greater awareness and understanding among health providers of the implications and reasons for missed appointments. The results can help to improve patient–provider relationships and deliver services that better meet patients’ needs and expectations.