BACKGROUND Across England, 12% of all improving access to psychological therapy (IAPT) appointments are missed, and on average around 40% of first appointments are not attended, varying significantly around the country. In order to intervene effectively, it is important to target the patients who are most likely to miss their appointments. OBJECTIVE This research aims to develop and test a model to predict whether an IAPT patient will attend their first appointment. METHODS Data from 19 adult IAPT services were analysed in this research. A multiple logistic regression was used at an individual service level to identify which patient, appointment and referral characteristics are associated with attendance. These variables were then used in a generalised linear mixed effects model (GLMM). We allow random effects in the GLMM for variables where we observe high service to service heterogeneity in the estimated effects from service specific logistic regressions. FINDINGS We find that patients who self-refer are more likely to attend their appointments with an OR of 1.04. The older a patient is, the fewer the number of previous referrals and consenting to receiving a reminder short message service are also found to increase the likelihood of attendance with ORs of 1.02, 1.10, 1.04, respectively. CONCLUSIONS Our model is expected to help IAPT services identify which patients are not likely to attend their appointments by highlighting key characteristics that affect attendance. CLINICAL IMPLICATIONS This analysis will help to identify methods IAPT services could use to increase their attendance rates.

中文翻译：

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预测患者参与IAPT服务的情况：电子健康记录的统计分析。

背景技术在整个英格兰，错过了改善心理治疗（IAPT）约会的所有机会的12％，平均约40％的第一次约会没有参加，在全国范围内差异很大。为了有效进行干预，重要的是针对最有可能错过约会的患者。目的这项研究旨在开发和测试一种模型，以预测IAPT患者是否会参加首次预约。方法本研究分析了19个成人IAPT服务的数据。在个体服务水平上使用多元逻辑回归来确定哪些患者，约会和转诊特征与出勤相关。然后，将这些变量用于广义线性混合效应模型（GLMM）。我们在变量中使用GLMM中的随机效应，在这些变量中，根据特定于服务的逻辑回归的估计效应，我们观察到较高的服务与服务异质性。结果我们发现，具有自我推荐能力的患者更有可能参加OR为1.04的约会。患者年龄越大，先前转诊的次数越少，并且同意接受提示性短消息服务的情况下，也分别增加OR值为1.02、1.10、1.04的出席可能性。结论我们的模型有望通过强调影响出勤的关键特征来帮助IAPT服务确定哪些患者不太可能参加其约会。临床意义该分析将有助于确定IAPT服务可用于提高出勤率的方法。