• Su-May Liew, Seng Fah Tong, Verna Kar Mun Lee, Chirk Jenn Ng, Kwok Chi Leong, and Cheong Lieng Teng.
• Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Malaysia. sumayliew@gmail.com
• Br J Gen Pract. 2009 Dec 1; 59 (569): 916920916-20.

BackgroundNon-attendance results in administrative problems and disruption in patient care. Several interventions have been used to reduce non-attendance, with varying degree of success. A relatively new intervention, text messaging, has been shown to be as effective as telephone reminders in reducing non-attendance. However, no study has looked specifically at using text messaging reminders to reduce non-attendance in chronic disease care.AimTo determine if text messaging would be effective in reducing non-attendance in patients on long-term followup, compared with telephone reminders and no reminder.Design Of StudyA randomised controlled trial with three arms: text messaging reminder, telephone reminder, and control.SettingTwo primary care clinics in Malaysia.MethodA total of 931 subjects who had been on at least 6 months of follow-up were randomised into the three groups. Demographic variables were recorded at the first visit. In the intervention arms, a reminder was sent 24–48 hours prior to the appointment. Non-attendance rate was documented at the second visit. Non-attenders were defined as those who did not attend, attended early, or attended late without rescheduling their appointment. Attenders were defined as participants who had turned up for their scheduled appointment and those who had changed or cancelled their appointment with notification.ResultsThe non-attendance rates in the text messaging group (odds ratio [OR] = 0.62, 95% confidence interval [CI] = 0.41 to 0.93, P = 0.020) and the telephone reminder group (OR = 0.53, 95% CI = 0.35 to 0.81), P = 0.003) were significantly lower than the control group. The absolute non-attendance rate for telephone reminders was lower by 2% compared to the text messaging group. This difference was not found to be statistically significant (P = 0.505).ConclusionText messaging was found to be as effective as telephone reminder in reducing non-attendance in patients who required long-term follow-up for their chronic illnesses in this study. It could be used as an alternative to conventional reminder systems.

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