ReviewBMC medicine2024
Understanding the causes of missingness in primary care: a realist review.
Review in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review and meta-analysis of no show or non-attendance rates among telehealth and in-person models of care.BMC health services research · 2025Pooled it
- Trial
- Feasibility study of the Care-at-Home Pharmacotherapy Service (CAHPS): pharmacy technician-led home visits for people receiving polypharmacy who are housebound living in socioeconomically deprived areas.International journal of clinical pharmacy · 2026Article
- [Patient-reported reasons for missed otolaryngology outpatient appointments].Anales del sistema sanitario de Navarra · 2026Observational
- Keeping PeopleInternational journal of social determinants of health and health services · 2026Article
- A scoping review of how the candidacy framework has been used in research on access to general practice.Journal of health services research & policy · 2026Article
- Addressing the causes of 'missingness' in healthcare: a co-designed suite of interventions.BMC medicine · 2026Article
- Primary Care or Primary Problem? Aligning Access Pathways with Patient Needs Across the Care Continuum.Journal of market access & health policy · 2026Article
- Absent or not invited? A multilevel qualitative study of patients and healthcare professionals' perspectives on barriers and enablers of outpatient attendance in Southern Denmark.BMC health services research · 2026Article
- Global Predictors of Appointment Non-Adherence in Primary Care Settings: A Systematic Review.Healthcare (Basel, Switzerland) · 2026Review
- Follow-up attendance and documented reasons for non-attendance in child and adolescent mental health care: a retrospective analysis.Frontiers in psychiatry · 2026Article
- What are we missing? Reflections on the 'problem' of missed appointments in the UK.NIHR open research · 2026Article
- Article
- Research Paper of the Year 2024: impact on the patient, the practitioner, the practice, and policy.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Can we tackle the inverse care law in general practice?The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Why Do Individuals with Diabetes Miss Their Dietitian Appointments? A Mixed-Methods Study on Barriers and Strategies for Improved Engagement in Diabetes Care.Healthcare (Basel, Switzerland) · 2025Article
- "Women's health (London, England)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough missed appointments in healthcare have been an area of concern for policy, practice and research, the primary focus has been on reducing single 'situational' missed appointments to the benefit of services. Little attention has been paid to the causes and consequences of more 'enduring' multiple missed appointments in primary care and the role this has in producing health inequalities.
methodsWe conducted a realist review of the literature on multiple missed appointments to identify the causes of 'missingness.' We searched multiple databases, carried out iterative citation-tracking on key papers on the topic of missed appointments and identified papers through searches of grey literature. We synthesised evidence from 197 papers, drawing on the theoretical frameworks of candidacy and fundamental causation.
resultsMissingness is caused by an overlapping set of complex factors, including patients not identifying a need for an appointment or feeling it is 'for them'; appointments as sites of poor communication, power imbalance and relational threat; patients being exposed to competing demands, priorities and urgencies; issues of travel and mobility; and an absence of choice or flexibility in when, where and with whom appointments take place.
conclusionsInterventions to address missingness at policy and practice levels should be theoretically informed, tailored to patients experiencing missingness and their identified needs and barriers; be cognisant of causal domains at multiple levels and address as many as practical; and be designed to increase safety for those seeking care.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.