The effect of SMS (text message) reminders on attendance at a community adult mental health service clinic: do SMS reminders really increase attendance?
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Non-attendance at outpatient clinics is common and costly.
This study aimed to determine if sending SMS (‘short message service’ or text message) reminders to patients before appointments reduced non-attendance.
We collected outpatient data at Ballyfermot and Lucan Community Adult Mental Health Service, Dublin, Ireland during 6-month periods (a) immediately prior to the introduction of SMS reminders for outpatient appointments; (b) immediately following the introduction of SMS reminders; and (c) two and a half years later.
In the 6-month period prior to SMS reminders, 2170 outpatient appointments were offered and there was a 22.2% non-attendance rate. In the 6-months following the introduction of SMS reminders, 2092 appointments were offered and the non-attendance rate fell to 13.9% (p < 0.001), with the lower non-attendance rate among those who did not receive SMS reminders (9.7%) rather than those who did (15.7%) (p = 0.0002). There were 98 appointment cancellations during this period (73% via SMS messaging). In the 6-month period two and a half years after the introduction of SMS reminders, 2474 appointments were offered and the non-attendance rate rose to 19.3%; this did not differ between those who received SMS reminders (19.3%) and those who did not (19.1%) (p = 0.38209) and was still lower than the rate prior to SMS reminders (p = 0.01321). During this period, 197 appointments were cancelled (75% via SMS messaging).
The chief value of SMS reminders lies not in reminding patients of appointments but in providing a convenient way to cancel them, thus allowing more appointments to be offered.
KeywordsNo-show patients Outpatient Psychiatry Text messaging Therapeutics
We wish to acknowledge the administration staff at Ballyfermot and Lucan Community Mental Health Team.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval was not obtained, as there was no patient contact at any time.
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