Heart Failure Clinic No-show Rates And Effect On Heart Failure Hospitalizations: A Real-World Experience From The Middle East

Abstract

<h3>Introduction</h3> Adherence to scheduled appointments in heart failure (HF) patients remains an important factor for optimum HF management. Recognizing patterns of adherence to appointments will provide insight and help to improve compliance in attending future HF clinics. <h3>Aim</h3> We aim to describe the frequency and characteristics of no-show appointments in relation to patient demographics and distance traveled, and evaluate the effect on HF hospitalizations in our newly established advanced HF program in the Middle East-Gulf Region. <h3>Methods</h3> A total of 230 patients who have been followed up in our HF clinic were included. Retrospective chart review was used to collect data on patients' demographics and adherence to appointments. Based on the average no-show rate, a head-to-head comparison was conducted using appropriate testing methods between those who were adherent (no-show rate ≤10%) vs. non-adherent (no-show rate >10%) patients. The comparison included the 12 months HF-admissions as well. <h3>Results</h3> A total of 1667 appointments were scheduled and confirmed. Patients did not show in 199 (11.9%) of the appointments, but attended an average of 6.5± 2 appointments during 12 months follow-up. Wednesday and Monday clinic appointments were more likely to be missed (32.6% and 24.1%, respectively). Afternoon appointments represented 57.8% of all missed appointments. Non-convenient appointment was the most documented reason for not showing (29.4%, Table.1). When comparing the adherent vs. the non-adherent group, (Table.2). Travel distance was similar in both groups. Males and smokers were more predominant in the non-adherent group (p=0.02 and p=0.02, respectively). The adherent group had a total of 35 HF hospitalizations compared to the non-adherent group who had a total of 42 HF hospitalizations (p=0.15). <h3>Conclusion</h3> This study explores important real-world data and adds to the available evidence on HF patient adherence. Highlighting key patient characteristics, including distance traveled to specialized HF programs increases our understanding and helps formulate future strategic planning to predict and reduce the impact of patient no-show rates and future HF hospitalizations.