Pos0748 Outpatient Non-Attendance in Rheumatology Consult and Its Relationship With Depression and Anxiety

Background: Non-attendance occurs when a patient neglects to attend a scheduled appointment without providing prior notice, presenting a notable challenge that can detrimentally impact patient health and well-being [1]. Patients who miss their appointments may face potential disruptions in their care, unnecessary emergency room admissions, and extended waiting times for future appointments. Rheumatic diseases contribute significantly to morbidity, potentially triggering psychological disorders such as anxiety and depression. This, in turn, can escalate morbidity, disability, and mortality rates [2]. Information on the influence of depression and anxiety on the non-attendance of rheumatic patients is limited. Objectives: To examine the prevalence of depression and anxiety among patients with autoimmune rheumatic diseases and their association with non-attendance at consultations. Methods: We conducted an observational retrospective study, encompassing patients with autoimmune rheumatic diseases (ARD) who missed at least one appointment between March and December 2023. These individuals had previously undergone assessment using the Hospital Anxiety and Depression Scale (HADS), with a score of 0 indicating no risk, 1-7 points signifying low risk, 8-10 points suggesting intermediate risk, and scores exceeding 11 indicating high risk. We categorized them into two groups: patients with regular attendance and those with non-attendance, matching them based on diagnoses. For statistical analysis, qualitative variables are depicted as frequencies and percentages, while quantitative variables are represented by distributions, including median and interquartile range (IQR). Chi-square was employed to compare differences between groups. Results: A total of 394 patients were included.The baseline patient characteristics are outlined in Table 1. The most common ARD was RA in 278 (70.6%) patients, followed by SLE 65 (16.5%), SS 12 (3%), SSC 10 (2.5%), RA+SLE 8 (2%), MCTD 7 (1.8%), APS (1.5%), IIM 4(1%), and SPA 4 (1%). The median HADS-A score was 3 (IQR 0-7) and HADS-D 0 (IQR 0.1) for anxiety and depression, respectively. The median age of the non-attendance group was 51 years (IQR 39-60) and the attendance group was 51 years (IQR 46-42). There was a significant difference between these groups (p=0.037). The median years of education in the non-attendance group was 9 years (IQR 6-12) and in the attendance group was 9 years (IQR 6-11). There was a significant difference between these groups (p=0.042) Among patients with rheumatoid arthritis, an intermediate-to-high risk for depression was observed in 9 (81.8%) patients in the non-attendance group compared to 2 (18.2%) patients in the attendance group. A significant difference was noted between the two groups (p=0.030). Conclusion: Our study found no significant association between non-attendance in patients with ARD and the risk of anxiety and depression. However, it is noteworthy that 59.4% of the non-attendance group showed a risk of anxiety, and 28.9% were at risk of depression. Interestingly, younger patients and those with higher education levels were more likely to miss appointments, highlighting the complex interplay of clinical and psychological factors in patient engagement. REFERENCES: [1] Leibner, G. et al. 'To charge or not to charge: Reducing patient no-show', Israel Journal of Health Policy Research, 2023;12(1). doi:10.1186/s13584-023-00575-8. [2] Jeffrey A, Aveka IA, Bashir AY, Umar A. Depression among patients with rheumatic musculoskeletal disorders attending tertiary hospital in northern nigeria. West Afr J Med. 2023; 10;40. PMID: 37976241. Table 1. Baseline Characteristics of Patients with Autoimmune Rheumatic Diseases (ARD) Based on Appointment Attendance and HADS Scores Acknowledgements: NIL. Disclosure of Interests: None declared.