Dear Editor,
Nonattendance is of great practical and economical importance to patients and the health care system alike. The degree of nonattendance may vary according to patients’ characteristics and may therefore influence the diagnosis and diagnostic delay. Nonattendance is associated with a low socioeconomic status, alcohol consumption, and obesity [1]. Patients with hidradenitis suppurativa (HS) often have a low socioeconomic status, suffer from obesity and related comorbidities [2]. Furthermore, a recent study has discovered a higher prevalence of substance use disorder in HS patients [3]. HS patients also use emergency rooms more often [4], which may be due to a lower show-rate in scheduled outpatient visits. Generally, HS patients experience a significant delay of diagnosis [5]. In accordance with the aforementioned literature on the characteristics of HS patients, we hypothesized that HS patients may have higher rates of no-shows compared with other dermatologic patients.
We conducted a prospective study at the Department of Dermatology, Zealand University Hospital, Roskilde, Denmark, and registered all no-shows of planned visits from February 26, 2018 to April 6, 2018. No-show rates in HS-specific clinics were compared with general dermatology outpatient clinics. Nursing clinics and surgeries were excluded. No-show rates were compared using the χ2 test. A total of 744 patients were included, hereof 113 (15%) were HS patients and 631 had other dermatologic conditions (Table 1). We found no significant difference in no-show rates between HS patients and other dermatologic patients (p = 0.688). Despite their comorbidities, obesity, lower socioeconomic status, and higher consumption of alcohol and other substances among HS patients, they manage to attend their scheduled outpatient visits to the same extent as other dermatologic patients. Several factors contribute to the prediction of no-show rates. A Danish study on nonattendance in dermatology found that erroneous scheduling was one of the main reasons for not showing up. The authors also investigated if the diagnosis was associated with no-show rate. However, HS patients were categorized as “other skin diseases” [6].
Table 1.
Nonattendance versus attendance of HS patients at outpatient visits
| Tsotal number of planned visits (n = 744) | Nonattendance | Attendance | % |
|---|---|---|---|
| (n = 103) | (n = 641) | (95% CI) | |
| HS patients (n = 113) | 17 | 96 | 17.7 (10.7–24.1) |
| Other dermatologic patients (n = 631) | 86 | 545 | 15.8 (12.9–18.6) |
In our study, we did not confirm the diagnosis of each patient, but all patients attended specialist clinics. We assumed that every patient scheduled for treatment on the HS program had HS, and patients scheduled in other outpatient programs did not have HS. Thereby, there may have been a small fraction of patients with other diagnoses in the HS program and vice versa. This limitation does not bias our study design. However, HS patients attending specialist clinics may have a more severe disease and thereby possibly a stronger motivation for attending scheduled visits. This may have contributed to our results showing that HS patients have the same no-show rates as other dermatologic patients.
Statement of Ethics
Studies of this type do not need an approval from the Institutional Review Board according to Danish law.
Disclosure Statement
P. Lindsø Andersen declares no conflicts of interest. J. Olsen received a PhD grant from the LEO foundation. G.B. Jemec has received honoraria from AbbVie, Coloplast, Pierre Fabre, InflaRx, Leo Pharma, and UCB for participation on advisory boards, honoraria and grants from Abbvie, InflaRx, Leo Pharma, UCB Janssen-Cilag, Regenreron, Sanofi, and Astra Zeneca for participation as principal investigator and stock option for participation on the advisory board. D.M. Saunte has received honoraria from Sanofi and Janssen for participation on advisory boards, honoraria as a speaker from Abbvie, Leo Pharma, and Astella and travel grants from Abbvie, Sanofi, and Pfizer.
References
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