Improving attendance in psychiatric outpatient clinics by using reminders

Abstract

We compared non-attendance rates at follow-up appointments in an adult psychiatry outpatient clinic using three different reminder methods: letters, telephone prompts and text message reminders. Two of the three strategies resulted in a significant increase in the rate of attendance. Reminder letters increased attendance from 62% to 85% (P<0.001) and text messaging increased attendance from 72% to 80% (P<0.002). The attendance rate was not significantly different between the two groups when telephone reminders were used (P=0.068). However, telephone prompts resulted in an 8% higher cancellation rate compared to controls. When all factors were taken into consideration, no method demonstrated clear superiority. Efforts should be made to reduce patient non-attendance, as this is a predictor of patients being unwell and at higher risk of relapse. Text messages are an inexpensive method of reminding patients, although appropriate safeguards for patient confidentiality are required.

Short message service (SMS) reminders improve treatment attendance in alcohol dependence, but are less effective for patients high in impulsivity

“…The increase in attendance observed is comparable to that reported by Downer et al (2006) in a children's outpatient clinic at another large Australian public hospital. It is also comparable to the 11% increase reported in British psychiatric outpatients (from a lower baseline of 72%; Kunigiri et al, 2014). This study provides consistent evidence for the effectiveness of SMS reminders in an outpatient alcohol-dependent population.…”

Fundamentals for Future Mobile-Health (mHealth): A Systematic Review of Mobile Phone and Web-Based Text Messaging in Mental Health

“…Other messaging interventions were proposed to patients during routine follow-up, without targeting any specific disorder. These applications were essentially appointment reminders for outpatients [ 53 , 54 ] and preventive information for disadvantaged patients [ 55 ].…”

New Frontiers in Healthcare and Technology: Internet-and Web-Based Mental Options Emerge to Complement In-Person and Telepsychiatric Care Options

“…Direct or remote education, motivation and support may increase attendance (i.e., treatment readiness), recognition of treatment benefits, and collaboration between care providers -all contribute to a positive psychiatric treatment [87]. Recent patient-centered strategies that increase patient attendance and adherence to treatment include simple mail, telephone or SMS reminders [88,89].…”

“…Direct or remote education, motivation and support may increase attendance (i.e., treatment readiness), recognition of treatment benefits, and collaboration between care providers -all contribute to a positive psychiatric treatment [87]. Recent patient-centered strategies that increase patient attendance and adherence to treatment include simple mail, telephone or SMS reminders [88,89].Internet-based CBT (ICBT) and other evidence-based treatments are most often for patients with depression and anxiety. ICBT appears to be effective when delivered in clinical practice (i.e., guided by a qualified therapist [90,91].…”