Clinical research studyThe Effectiveness of Outpatient Appointment Reminder Systems in Reducing No-Show Rates
Section snippets
Study Population
We performed a prospective, randomized, parallel design clinical trial in the Department of Medicine at the Robert Wood Johnson University Medical Group, an outpatient multispecialty practice of the University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School. Study enrollees were patients in 1 or more of 10 specialty outpatient practices: heart transplantation, rheumatology, pulmonary, nephrology, hematology, general internal medicine, gastroenterology, endocrinology,
Study Population
From March to July 2007, 13,505 patients were scheduled for appointments (Figure 1). For technical reasons, data for 9 days were removed from the final analysis because they were not uploaded to the automated appointment reminder system. This resulted in 1413 patients not randomized. The remaining 12,092 patients were randomized to the following groups: Clinic Staff Reminder STAFF (n = 3266), Automated Appointment Reminder AUTO (n = 3219), or NONE (n = 3350). The appointments of 2257 patients were
Discussion
A 1992 meta-analysis of various studies showed that a reminder can be used to decrease the no-show rate.10 A case-control trial of 1296 appointments from a Swiss university outpatient clinic showed a no-show rate of 15.8%.11 Our study's no-show rates were consistent with previous studies showing no-show rates ranging from 2% to 30%.11, 12, 13, 14, 15 Our prospective, randomized study on 13,505 appointments demonstrated a lower no-show rate with a clinic staff reminder compared with an automated
Study Limitations
Limitations included the difference between the number of call attempts between the Clinic Staff Reminder (STAFF) and Automated Appointment Reminder (AUTO) groups, the difference in time of day when calls were made in the Clinic Staff Reminder and Automated Appointment Reminder groups, and only patients who arrived to their appointments were surveyed. Another limitation is that patients may have multiple appointments scheduled on the same day, which would decrease the likelihood of a no-show.
Conclusions
The clinic staff reminder significantly reduced the no-show rate. Although the automated reminder system was significantly less effective, it likely has a cost advantage making it more attractive. Further economic evaluation is required to confirm that the reduction in no-shows compensates for the increased cost of using a clinic staff reminder. Future studies also might explore the use of other reminder systems: electronic mail, cell phone voice message reminders, or text messaging. This may
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Funding: None.
Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript.
Authorship: All authors had access to the data and played a role in writing this manuscript.