31 When IBD Patients Miss Clinic: The Leading Causes of No-Shows

Background: Inflammatory bowel disease (IBD) requires regular follow-up to optimize disease control and prevent complications. Missed appointments (“no-shows”) disrupt continuity of care and may be more prevalent in urban populations facing socioeconomic disparities. Limited data exist describing the reasons for non-attendance to IBD clinics in urban centers with known barriers to healthcare access. Methods: We conducted a retrospective review of all scheduled visits at a tertiary IBD clinic at an urban academic center over a 12-month period. Baseline demographics and clinical data were extracted from the electronic medical record for unique patients with documented no-shows. A structured telephone survey was administered to assess perceived reasons for non-attendance, transportation factors, rescheduling attempts, and suggested interventions. Responses were summarized descriptively, and zip code–based distance was examined for potential patterns. Results: Forty-three unique patients were identified. Mean age was 47.1 ± 15.2 years; 46.5% were female. Racial/ethnic distribution included Black (76.7%), White (16.3%), White-other (4.7%), and Unknown (2.3%). Most visits were in-person (76.7%), with an average distance of 13.5 ± 28.0 miles. Diagnoses included Crohn’s disease (69.8%), ulcerative colitis (18.6%), and indeterminate/unspecified IBD (11.6%). Hospitalization within the prior year occurred in 37.2%. Eleven patients completed the survey. Transportation barriers were the most frequently cited reason for non-attendance (38%), followed by forgetting the appointment (15%) and wanting an earlier appointment (15%). Among transportation barriers, the most common were no access to a car (28.6%), wheelchair transport issues (14.3%), cancelled transportation (14.3%), distance (14.3%), cost (14.3%), and insurance limitations (14.3%). Forty percent attempted to reschedule, with some reporting delays or inability to secure a new date. Patient suggested strategies included transportation assistance (35.7%), flexible scheduling (28.6%), and appointment reminders (7.1%). Zip code–based analysis did not reveal a statistically significant relationship between distance and reported transportation barriers, although patients more than 20 miles from the center trended toward more reported access issues. Conclusions: In this urban IBD cohort, transportation challenges and appointment forgetfulness were the leading contributors to no-show rates. Targeted reminders, flexible scheduling, guidance for accessing video visits, and transportation support may reduce missed visits and improve continuity of IBD care.