Understanding issues associated with attending a young adult diabetes clinic: a case study

Aims To study the reasons for attendance behaviour from the patient viewpoint at a young adult diabetes outpatient clinic.
Methods Attendance rates for 231 clinic appointments over 19 months for 102 patients were calculated. Semi-structured
interviews were conducted with a purposive sample of 17 of the 102. The interviews encouraged participants to describe
routines, thoughts and feelings around clinic appointments. Observations were made of the clinic system. Themes arising from
patients’ emotional and practical issues around attendance were generated from the data.
Results ‘Did not attend’ rates for the clinic over the study period were 15.7%.However, bureaucratic problems created many
‘missed’ appointments;most instances of ‘did not attend’ investigated were attributable to communication failures. Participants
did not divide neatly into ‘attenders’ ⁄ ’non-attenders’;many had complexmixed attendance records. Most weighed the value of
attendance against immediate obstacles such as incompatiblework⁄ clinic hours. Reminderswere seen as important, particularly
for this age group. Respondents identified fear of being judged for ‘poor control’ as a major factor in attendance decisions,
suggesting that having a high HbA1c level may lead to non-attendance, rather than vice versa.
Conclusions Health professionals’ supportive, non-judgemental attitude is important to patients considering clinic
attendance. In this study, improved communication, reminders and flexible hours might reduce ‘did not attend’ rates.