Attention-deficit/hyperactivity disorder and serial missed appointments in general practice.

Area of Science:

• Healthcare Management
• Psychiatry
• Public Health

Background:

• Healthcare 'missingness,' particularly missed appointments, is linked to poor patient outcomes and increased mortality.
• Patients with mental health conditions, including Attention-Deficit/Hyperactivity Disorder (ADHD), often struggle with consistent healthcare access.
• ADHD affects an estimated 2-5% of the population, making its impact on appointment adherence a significant concern.

Purpose of the Study:

• To determine the prevalence of recorded ADHD in Scottish general practices.
• To compare individuals with and without ADHD based on health and social factors.
• To assess the association between ADHD and the likelihood of missing general practice appointments.

Main Methods:

• Utilized administrative data from 136 Scottish general practices (September 2013-2016).
• Identified ADHD cases using diagnostic and prescribing records, matched to controls by age and sex.
• Analyzed health, social status, and missed appointment data, stratified by age (<18 and ≥18 years).

Main Results:

• Identified 2,452 individuals with ADHD (0.8% <18 years; 0.2% ≥18 years) among 824,374 GP patients.
• ADHD was associated with social deprivation and higher multimorbidity in adults.
• ADHD increased the risk of missing GP appointments (OR 1.6 for <18 years; OR 1.9 for ≥18 years), even after adjusting for total appointments.

Conclusions:

• The recorded prevalence of ADHD in Scottish general practice is low but consistent with other record-based studies.
• This study is the first to establish a clear link between ADHD and missed general practice appointments.
• Findings emphasize the importance of early ADHD diagnosis and tailored interventions to enhance healthcare continuity and patient outcomes.