Potential impact of text message reminders on non-attendance at outpatient clinics

Hogan, Aisling; Cormack, Orla Mc; Traynor, Oscar; Winter, D. C.

doi:10.1007/s11845-008-0187-2

Cited by 22 publications

(16 citation statements)

References 13 publications

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“…In a survey of patients who had failed to attend a general surgical outpatient clinic appointment, Hogan et al 20 report that a 'text message reminder would have encouraged 51% (n = 49) to have either attended the appointment or contacted the hospital to cancel'. However, the way that SMS reminders are delivered varied across studies, hence influencing the way that they are used to cancel or reschedule.…”

Section: Findings From Other Studiesmentioning

confidence: 99%

“…20,[111][112][113][114] Studies also suggest that health-care professionals perceive forgetfulness to be one of the most important reasons for non-attendance. 104 However, the evidence from multiple studies indicates that forgetting to attend accounted for between 8% 112 and 45% of the patients who did not attend their appointments, 74 suggesting that other factors are also in operation in many settings.…”

Section: Reported Reasons For Non-attendancementioning

confidence: 99%

“…135 It has also been suggested that when appointments are scheduled a long time in advance, patient symptoms may be resolved, either because they resolve themselves or because the patient (or referring health-care professional) opts to seek alternative care. For instance, an Irish study that examined appointments in a general surgical outpatients department 20 revealed that resolution of symptoms accounted for almost one-third of missed appointments. The authors suggested that this finding questions the appropriateness of some referrals and suggests that many patients might be managed in the primary care setting.…”

Section: Explanations and Implications For Remindersmentioning

confidence: 99%

“…As discussed above under Time to wait to the appointment, the higher levels of non-attendance with longer wait to appointment have been explained in part by the resolution of symptoms in the interim period. A study 20 in a general surgical clinic in Ireland revealed resolution of symptoms to account for almost one-third of missed appointments. The authors questioned the appropriateness of referral, suggesting that many patients might be managed in the primary care setting.…”

Section: Symptomatology and Severitymentioning

confidence: 99%

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Targeting the Use of Reminders and Notifications for Uptake by Populations (TURNUP): a systematic review and evidence synthesis

McLean

Gee

Booth

et al. 2014

Health Services and Delivery Research

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BackgroundMissed appointments are an avoidable cost and a resource inefficiency that impact on the health of the patient and treatment outcomes. Health-care services are increasingly utilising reminder systems to counter these negative effects.ObjectivesThis project explores the differential effect of reminder systems for different segments of the population for improving attendance, cancellation and rescheduling of appointments.DesignThree inter-related reviews of quantitative and qualitative evidence relating to theoretical explanations for appointment behaviour (review 1), the effectiveness of different approaches to reminding patients to attend health service appointments (review 2) and factors likely to influence non-attendance (review 3).Data sourcesDatabase searches were conducted on Allied and Complementary Medicine, Cumulative Index to Nursing and Allied Health Literature Plus with Full Text, The Cochrane Library, EMBASE (via NHS Evidence from 1 January 2000 to January/February 2012), Health Management Information Consortium database, Institute of Electrical and Electronics EngineersXplore, The King’s Fund Library Catalogue, Maternity and Infant Care, MEDLINE, Physiotherapy Evidence Database, PsycINFO, SPORTDiscus and Web of Science from 1 January 2000 to January/February 2012. Supplementary screening of references of included studies was conducted to identify additional potentially relevant studies. Conceptual papers were identified for review 1, randomised controlled trials (RCTs) and systematic reviews for review 2 and a range of quantitative and qualitative research designs for review 3.MethodsWe conducted three inter-related reviews of quantitative and qualitative evidence, involving a review of conceptual frameworks of reminder systems and adherence behaviours, a review of the reminder effectiveness literature and a review informed by realist principles to explain the contexts and mechanisms that explain reminder effectiveness. A preliminary conceptual framework was developed to show how reminder systems work, for whom they work and in which circumstances. Six themes emerged that potentially influence the effectiveness of the reminder or whether or not patients would attend their appointment, namely the reminder–patient interaction, reminder accessibility, health-care settings, wider social issues, cancellation and rebookings, and distal/proxy attributes. Standardised review methods were used to investigate the effectiveness of reminders to promote attendance, cancellation or rebooking across all outpatient settings. Finally, a review informed by realist principles was undertaken, using the conceptual framework to explain the context and mechanisms that influence how reminders support attendance, cancellation and rebooking.ResultsA total of 466 papers relating to 463 studies were identified for reviews 2 and 3. Findings from 31 RCTs and 11 separate systematic reviews (review 2 only) revealed that reminder systems are consistently effective at reducing non-attendance at appointments, regardless of health-care setting or patient subgroups. Simple reminders that provide details of timing and location of appointments are effective for increasing attendance at appointments. Reminders that provide additional information over and above the date, time and location of the appointment (‘reminder plus’) may be more effective than simple reminders at reducing non-attendance and may be particularly useful for first appointments and screening appointments; simple reminders may be appropriate thereafter for most patients the majority of the time. There was strong evidence that the timing of reminders, between 1 and 7 days prior to the appointment, has no effect on attendance; substantial numbers of patients do not receive their reminder; reminders promote cancellation of appointments; inadequate structural factors prevent patients from cancelling appointments; and few studies investigated factors that influence the effectiveness of reminder systems for population subgroups.LimitationsGenerally speaking, the systematic review method seeks to provide a precise answer to a tightly focused question, for which there is a high degree of homogeneity within the studies. A wide range of population types, intervention, comparison and outcomes is included within the RCTs we identified. However, use of this wider approach offers greater analytical capability in terms of understanding contextual and mechanistic factors that would not have been evident in a more narrowly focused review and increases confidence that the findings will have relevance in a wide range of service settings.ConclusionsSimple reminders or ‘reminder plus’ should be sent to all patients in the absence of any clear contraindication. Other reminder alternatives may be relevant for key groups of patients: those from a deprived background, ethnic minorities, substance abusers and those with comorbidities and/or illnesses. We are developing a practice guideline that may help managers to further tailor their reminder systems for their service and client groups. We recommend future research activities in three main areas. First, more studies should routinely consider the potential for differential effects of reminder systems between patient groups in order to identify any inequalities and remedies. Second, ‘reminder plus’ systems appear promising, but there is a need for further research to understand how they influence attendance behaviour. Third, further research is required to identify strategies to ‘optimise’ reminder systems and compare performance with current approaches.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Findings From Other Studiesmentioning

confidence: 99%

Section: Reported Reasons For Non-attendancementioning

confidence: 99%

Section: Explanations and Implications For Remindersmentioning

confidence: 99%

Section: Symptomatology and Severitymentioning

confidence: 99%

See 2 more Smart Citations

Targeting the Use of Reminders and Notifications for Uptake by Populations (TURNUP): a systematic review and evidence synthesis

McLean

Gee

Booth

et al. 2014

Health Services and Delivery Research

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Dear Editor, We read with interest the publication by Hogan AM et al [1], which looked at the potential impact of text message reminders on non-attendance at surgical outpatient (OPD) clinics in Ireland and reported that such a service would encourage 51% to attend or cancel their missed OPD appointment. As the authors pointed out, little work has been carried out in this area in Ireland.

…”

mentioning

confidence: 99%

Clinic appointment reminders among rheumatology patients

et al. 2009

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Dear Editor, We read with interest the publication by Hogan AM et al. [1], which looked at the potential impact of text message reminders on non-attendance at surgical outpatient (OPD) clinics in Ireland and reported that such a service would encourage 51% to attend or cancel their missed OPD appointment. As the authors pointed out, little work has been carried out in this area in Ireland. Recently, we also examined the topic, focusing on Rheumatology patients attending our outpatient services, who had a ''did not attend'' (DNA) rate of almost 18% (525/2,924) in 2007 [2] compared to 16.8% in the Hogan AM et al. study.Many patients DNA their OPD clinic appointments for one reason or another, for example a lapse in memory or forgetfulness has been estimated for up to 50% of DNA cases [3,4]. The level of DNA can be extremely high in many departments. In the department of care for the elderly at Hammersmith Hospital, London, in 1996-1997, DNA rates were a staggering 21% [5]. This is at the backdrop of a national mean DNA rate of 12% for all clinics in the UK for the same period [6]. These results compare to 16% forgetting their appointment in Hogan et al. with 20% due to clerical errors.DNA has many implications for both the patients and the services involved. Regarding the patient, missed valuable clinical input may result in suboptimal health. This is very well documented among the diabetic population where patients who DNA clinic appointments have significantly greater risk factors and complications from their chronic condition [7]. Focusing on the services provided, the implications include vacant clinic appointments, which can be a waste of scarce financial resources.In our study, we conducted a cross-sectional selfadministered anonymous questionnaire with 166 patients (159 return patients) who attended Rheumatology clinics at the South Infirmary, Victoria University Hospital, Cork, Ireland. Patients were recruited intermittently, but consecutively, while the researchers were in attendance between September and October 2007. A response rate of 98% (163/166) was achieved. New patients were not analysed due to low numbers. Ninety-eight percentage (156/ 159) of return patients responded.Overall, 99% felt OPD appointment reminders to be a good idea. Interestingly, on logical regression analysis, those who had previously attended OPD were significantly more likely to view reminders as a positive idea (P \ 0.0005, OR = 57.72, 95% CI 15.14-220.03). This may suggest that those who have had more OPD exposure appreciate the possibility of missed appointments and the benefits of reminders. These findings were recorded in a setting of 65% (104), 16% (26), 96% (153), 59% (94), and 46% (73) having competence in or access to a mobile phone SMS, e-mail, a landline telephone, a landline voice messaging service and a mobile phone voice messaging service, respectively.Text/SMS messaging (47%) is the most preferred method of appointment reminder followed by a telephone call (26%) and postal letter (25%). The mean age of those

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Fine for non‐attendance in public hospitals in Denmark: A survey of non‐attenders' reasons and attitudes

Væggemose

Blæhr

Thomsen

et al. 2020

Health Planning & Management

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Summary Objective To investigate non‐attending patients' reasons for non‐attendance and their general and specific attitudes towards a non‐attendance fine. Data sources Non‐attenders at two hospital departments participating in a trial of fine for non‐attendance from May 2015 to January 2017. Design A quantitative questionnaire study was conducted among non‐attenders. Data collection Non‐attending patients in the intervention group were invited to complete the questionnaire. The response rate was 39% and the total number of respondents was 71 individuals. Principal findings The main reason for non‐attendance was technical challenges with the digital appointment and with cancelation. The main part of the respondents was generally positive towards a fine for non‐attendance. However, approximately the half had a negative attitude towards the actual fine issued. Conclusions Technical challenges with appointments and cancelation should get special attention when addressing non‐attendance. Danish non‐attending patients are primarily positive towards the general principle of issuing a fine for non‐attendance. However, a significant proportion of the generally positive, reported a negative specific attitude to the specific fine issued to them. This, however, did not affect their general attitude.

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Potential impact of text message reminders on non-attendance at outpatient clinics

Abstract: The rate of non-attendance is 17%. A reminder would eradicate more than half of non-attendance, allowing significantly more new patients to be seen, translating to more efficient use of clinic time.

Cited by 22 publications

References 13 publications

Targeting the Use of Reminders and Notifications for Uptake by Populations (TURNUP): a systematic review and evidence synthesis

Targeting the Use of Reminders and Notifications for Uptake by Populations (TURNUP): a systematic review and evidence synthesis

Clinic appointment reminders among rheumatology patients

Fine for non‐attendance in public hospitals in Denmark: A survey of non‐attenders' reasons and attitudes

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