Assessment of different intervention models to decrease no-show rates of embedded pharmacy visits

Clinical pharmacist practitioners (CPPs) are embedded in several Duke Primary Care (DPC) clinic locations. CPPs are able to independently modify medications and order labs within protocol in collaboration with a supervising physician. Patient no-shows for CPP appointments are costly to clinics. The purpose of this study was to determine the impact of 2 interventions on patient no-show rates for CPP appointments and to identify barriers patients may face that lead to no-shows.

Determine if the interventions were associated with a change in the no-show rate for embedded DPC CPP appointments.

Single-center, prospective, intervention study of no-show rates of DPC clinical pharmacist appointments. Appointments with patients under 18 years of age were excluded. Interventions were implemented between September 2023 and November 2023. The interventions consisted of a reminder message sent to the patient or a conversion of an in-person visit to a virtual visit if the patient was more than 5 minutes late. The intervention groups were compared to a control group from 1 year prior. A chi-square test was used to compare no-show rates.

Total of 1645 appointments were included. The no-show rate was 20.4% in the control arm, 18.0% in the patient portal message arm, and 15.7% in the virtual arm. Average estimated financial loss per day due to no-shows was numerically lower in the intervention groups compared to the control group.

The 2 intervention groups experienced numerically lower no-show rates in comparison to the control, but the differences were not statistically significant. We were not able to identify specific patient barriers that were associated with increased likelihood to no-show. More studies are needed to further evaluate the impact of these interventions. Next steps involve the feasibility and implementation of these interventions into clinic workflow on a long-term basis.