Reducing Missed Appointments for Patients With HIV: An Evidence-Based Approach

J Nurs Care Qual. 2020 Apr/Jun;35(2):165-170. doi: 10.1097/NCQ.0000000000000434.

Abstract

Background: High rates of missed appointments for routine HIV care are associated with unsuppressed viremia, increasing morbidity.

Local problem: The Clinic no-show rate ranged between 30% and 35%, and only 69% of patients were considered retained in care within a 24-month time frame.

Methods: The Woodward Risk Prediction Tool was completed on all patients to stratify patient risk for missing the next appointment.

Interventions: All patients were offered text message along with standard phone message appointment reminders, and patients who missed appointments were called within 24 hours to reschedule. Medium-risk patients received a previsit planning call to remove barriers to appointment attendance, and high-risk patients received a home visit from the peer navigator.

Results: The project resulted in a 3.8% reduction rate in the overall no-show rate in the first 5 months of implementation. Using risk stratification and targeted interventions allowed valuable resources to be allocated where they were needed.

MeSH terms

  • Adult
  • Appointments and Schedules*
  • Female
  • HIV Infections* / epidemiology
  • HIV Infections* / mortality
  • House Calls
  • Humans
  • Male
  • Reminder Systems / statistics & numerical data*
  • Telephone / statistics & numerical data*
  • Text Messaging / statistics & numerical data*
  • United States / epidemiology