LAUSR

OBJECTIVES 1) To identify the rate of short-notice cancelled appointments in a large national sample of persons with multiple sclerosis (MS) and 2) examine the demographic and clinical factors associated with frequent cancellations. DESIGN Retrospective cross-sectional cohort using electronic health records. SETTING Veterans Health Administration (VA). PARTICIPANTS Veterans with MS (N = 3,742) who were part of the VA MS Center of Excellence Data Repository and 1) had at least one outpatient appointment at the VA in 2013, 2) were alive in 2015, and 3) were prescribed a disease modifying therapy (DMT). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Frequent short-notice cancellations, defined as >20% of scheduled appointments cancelled with less than 24-hour notification over a 24-month period. This threshold was based on the definition of ≤80% for suboptimal treatment adherence. Several demographics and clinical variables were examined as potential explanatory factors. RESULTS Approximately 75% (n = 2,827) had at least one short-notice cancellation, with more than 3% (n = 117) being categorized as frequent cancellers. The odds of frequent cancellations were greater in women (OR = 1.81, p = .004) and among 18-44 year-olds (OR = 2.77, p =.004) and 45-64 year-olds (OR = 2.49, p = .003) compared to 65+ year-olds. The odds were lower among persons who lived <25 miles away (OR = 0.58, p = .043) compared to persons who lived ≥75 miles away, and those who had at least one ER visit (OR = 0.55, p = .012). CONCLUSIONS Short-notice cancellations are common in persons with MS, although few have more than 20%. These findings highlight who is at greater risk for frequent cancellation and disruptions in their care. While additional research is needed, the results provide insights into how clinics may approach handling frequent short-notice cancellations among persons with MS.