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Family Practice Advance Access published online on August 17, 2006
Family Practice, doi:10.1093/fampra/cml044
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© The Author (2006). Published by Oxford University Press. All rights reserved.
Received March 1, 2006
Accepted July 5, 2006

Article

The use of text messaging to improve attendance in primary care: a randomized controlled trial

Kwok Chi Leong 1 *, Wei Seng Chen 2, Kok Weng Leong 3, Ismail Mastura 4, Omar Mimi 5, Mohd Amin Sheikh 6, Abu Hassan Zailinawati 7, Chirk Jenn Ng 8, Kai Lit Phua 1, and Cheong Lieng Teng 1

1 International Medical University
2 Klinik Alam Medic, Puchong
3 Klinik Leong, Puchong
4 KK Ampangan
5 KK Kelana Jaya
6 Klinik Kota Bharu
7 Klinik Keluarga, Wangsa Maju
8 University Malaya

* To whom correspondence should be addressed.
Kwok Chi Leong, E-mail: leongk{at}pc.jaring.my


  Abstract

Background. Non-attendance is common in primary care and previous studies have reported that reminders were useful in reducing broken appointments.

Objective. To determine the effectiveness of a text messaging reminder in improving attendance in primary care.

Design. Multicentre three-arm randomized controlled trial.

Setting. Seven primary care clinics in Malaysia.

Participants. Patients (or their caregivers) who required follow-up at the clinics between 48 hours and 3 months from the recruitment date.

Interventions. Two intervention arms consisted of text messaging and mobile phone reminders 24-48 hours prior to scheduled appointments. Control group did not receive any intervention.

Outcome measures. Attendance rates and costs of interventions.

Results. A total of 993 participants were eligible for analysis. Attendance rates of control, text messaging and mobile phone reminder groups were 48.1, 59.0 and 59.6%, respectively. The attendance rate of the text messaging reminder group was significantly higher compared with that of the control group (odds ratio 1.59, 95% confidence interval 1.17 to 2.17, P = 0.005). There was no statistically significant difference in attendance rates between text messaging and mobile phone reminder groups. The cost of text messaging reminder (RM 0.45 per attendance) was lower than mobile phone reminder (RM 0.82 per attendance).

Conclusions. Text messaging reminder system was effective in improving attendance rate in primary care. It was more cost-effective compared with the mobile phone reminder.

Keywords: Reminder; primary care; non-attendance; text messaging; randomized controlled trial (RCT).
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