Patients with mental health conditions who missed general practitioner (GP) appointments repeatedly are at higher risk for mortality than those with physical disorders, finds a new study.

One possible mechanism mediating the relationship involves conditions associated with cognitive impairment such as dementia or alcohol and drug use. The study found that the more long-term conditions (LTC) a person had, the more likely they were to miss appointments. 

LTC is a condition that cannot be cured at present but can be controlled by medication and other therapies. For the study, the researchers included 824,374 patients. Findings published in the open access journal BMC Medicine showed that mental-health-based LTCs were found to be associated with a higher risk of missing appointments than physical LTCs.

One to three mental health comorbidities were associated with a 30 per cent higher risk of missing appointments compared to those who had no LTCs. In addition, patients with four or more mental health LTCs were twice as likely to miss appointments. 

"Patients with a higher number of missed appointments were also at greater risk of death within the following year. Those with long-term physical conditions who missed two or more appointments per year had a threefold increase in all-cause mortality compared with those who missed no appointments," said lead author Ross McQueenie, Research Associate at the Universities of Glasgow in Britain.

"Patients with only mental health conditions who missed more than two appointments per year had an eightfold increase in all-cause mortality compared with those who missed no appointments," said McQueenie. 

Patients diagnosed with long-term mental health problems, who died during the follow-up period, were more likely to die prematurely, often due to external factors such as suicide, rather than of natural causes, according to the team. While, further research is needed to better understand the relationship between missed appointments and mortality, GPs may need to consider how to best engage with patients who repeatedly miss appointments, researchers suggested.