Improving attendance in psychiatric outpatient clinics by using reminders

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.