eP327 - Predictors of Missed Hospital Appointments in Patients with Posterior Compartment Pelvic Floor Disorders in a Tertiary Referral Center

Purpose/Background: Missed hospital appointments pose a major challenge to the healthcare system and lead to worse patient care, health outcomes and waste healthcare resources. Around 1 in 10 hospital appointments are missed every year in the NHS costing approximately £120 per missed appointment. No studies have explored reasons for missed hospital appointments in patients with posterior pelvic floor disorders. We aim to ascertain sociodemographic and clinical characteristics of patients with posterior pelvic floor disorders who missed appointments and identify associated risk factors.Methods/Interventions: This is a single institution, retrospective study of patients referred to a tertiary colorectal pelvic floor unit (PFU) at Guy’s and St Thomas’ Hospital, London between March 2013 to May 2019. An appointment was marked missed if patients 1) did not attend without informing or asking to re-schedule or 2) if, when the appointment was left open for 6 months and patient did not contact to inform about their decision. Data was collected for socio-demographics including ethnicity (White British and other, Black British, Caribbean and other, Asian, Mixed and Others), socio-economic status proxied by English Indices of Deprivation measure 2019 (IMD) and clinical factors. Data was analysed after excluding missing values, where p-value < 0.05 was considered significant.Results/Outcomes: Initially 2002 patients were referred to PFU, of which 1707(85.3%) were females. Mean age of the patients referred was 52.8 +/- 15.6 years. Patients were referred with symptoms of obstructive defaecation (ODS) (825), anal incontinence(505), both(412), rectal prolapse(85), other complaints such as rectal bleeding and pain(92) and middle compartment prolapse with defaecatory problems(38). There was an increase in the proportion of appointments missed along the course of treatment pathway. Forty-five patients(2.24%) missed telephone triage assessment clinic (telephone assessment of symptoms and severity), 309(15.8%) missed face to face biofeedback clinic (conservative management) and 476(24.3%) missed diagnostic tests. Nearly half of the patients 768(48.5%) did not complete their biofeedback treatment.Table 1 shows sociodemographic and clinical characteristics of patients and their association with missed appointments. Missing TTAC was associated with male gender, age < 50 years, mixed and other ethnicity and other complaints such as rectal bleeding or pain. Missing BFB and diagnostic tests was associated with male gender, lower socio-economic status and anal incontinence. Not completing treatment was associated with age < 50 years, lower socio-economic status, anal continence, other complaints such as rectal bleeding and pain, and high volume rectal irrigation.Conclusion/

Discussion: Our study provides important preliminary data regarding socio-demographic and clinical factors associated with missed appointments in patients presenting with posterior compartment pelvic floor disorders. Future prospective research, including qualitative studies interviewing patients who miss their appointments, are needed to identify and address factors and potential barriers patients face when accessing care for posterior compartment pelvic floor disorders. This will not only improve patient outcomes but also increase clinicians' efficiency, productivity, and better use of limited health care resources.Table 1 for the abstractTable 1 shows sociodemographic and clinical characteristics of patients with posterior pelvic floor disorders, who missed along treatment pathway.