A research article in PLOS ONE finds that stating appointment costs in SMS reminders reduces missed hospital appointments
Missed hospital appointments are a major cause of inefficiency worldwide. Healthcare providers are increasingly using Short Message Service reminders to reduce ‘Did Not Attend’ (DNA) rates. Systematic reviews show that sending such reminders is effective, but there is no evidence on whether their impact is affected by their content.
The researchers undertook two randomised controlled trials that tested the impact of rephrasing appointment reminders on DNA rates in the United Kingdom.
Participants were outpatients with a valid mobile telephone number and an outpatient appointment between November 2013 and January 2014 (Trial One, 10,111 participants) or March and May 2014 (Trial Two, 9,848 participants). Appointments were randomly allocated to one of four reminder messages, which were issued five days in advance. Message assignment was then compared against appointment outcomes (appointment attendance, DNA, cancellation by patient).
In Trial One, a message including the cost of a missed appointment to the health system produced a DNA rate of 8.4%, compared to 11.1% for the existing message. Trial Two replicated this effect (DNA rate 8.2%), but also found that expressing the same concept in general terms was significantly less effective (DNA rate 9.9%.
The “General Costs” message was constructed to present the concept of costs in more general terms. Creating a more general message is attractive for practical reasons, since it requires less effort to adopt at scale (specific costs do not have to be calculated).
The researchers conclude that moving from the existing reminder to the more effective costs message would result in 5,800 fewer missed appointments per year in the National Health Service Trust in question.
The full research article can be read here.
Stating Appointment Costs in SMS Reminders Reduces Missed Hospital Appointments: Findings from Two Randomised Controlled Trials; Michael Hallsworth, Dan Berry, Michael Sanders, Anna Sallis, Dominic King, Ivo Vlaev, Ara Darzi: Published: September 14, 2015: DOI: 10.1371/journal.pone.0137306