Assessment of Missed Appointments at a Tertiary Referral Ocular Immunology Clinic

Identify demographic and clinical factors associated with missed appointments among patients with ocular inflammatory diseases at a tertiary ocular immunology clinic.

This retrospective coho rt study included 222 unique patients (316 appointments) with at least one missed appointment between June 2022 and June 2023 at the Wilmer Eye Institute. Demographic, clinical, and treatment data were extracted from electronic health records. Two patient-level outcomes were evaluated using multivariate regression: total no-show count and recurrent no-show patterns (≥2 missed visits). Models were adjusted for age, sex, race, ADI, insurance, travel distance, disease characteristics, and treatment factors.

The cohort comprised 222 patients (mean age 47.7 ± 19.1 years; 60.5% female; 69.1% African American; 76.2% with uveitis). Patients missed a mean of 1.4 ± 0.9 appointments, and 29.3% exhibited recurrent no-show patterns (≥2 missed visits). In multivariate analysis, no factors significantly predicted total no-show count (all p > 0.05). However, male gender (OR = 2.6, 95% CI 1.26-5.39, p = 0.01) and corticosteroid drop use (OR = 2.76, 95% CI 1.24-6.13, p = 0.013) were independent predictors of recurrent no-show patterns. Travel distance, ADI, insurance type, age, race, and disease laterality were not significant predictors.

While sporadic missed appointments occur uniformly across patient groups, recurrent no-show patterns specifically emerge among male patients and those with active disease requiring topical corticosteroids. This suggests distinct mechanisms underlying occasional versus habitual non-attendance behaviors. Targeted interventions focused on these high-risk subgroups may more effectively improve adherence and continuity of care in tertiary uveitis settings.