Encouraging attendance at outpatient appointments: can we do more?

Area of Science:

• Health Services Research
• Patient Adherence Studies

Background:

• Non-attendance at new outpatient appointments presents a significant challenge for healthcare systems.
• Missed appointments lead to delayed treatment for patients and inefficient resource allocation.

Purpose of the Study:

• To evaluate the effectiveness of appointment reminders in increasing attendance rates for new outpatient appointments.
• To assess the impact of reminders on reducing 'Did not Attend' (DNA) rates.

Main Methods:

• A comprehensive literature review was conducted.
• Electronic databases were searched using Medical Subject Headings (MeSH) and keywords.
• Reference lists of identified papers were reviewed for additional relevant studies.

Main Results:

• Telephone and postal reminders show effectiveness, particularly when delivered within 24 hours of the appointment.
• Enhanced postal reminders (offering rewards, threatening sanctions, providing clinic information) were more effective than standard reminders.
• No studies on e-mail or text message reminders were found; many studies were from psychiatric settings outside the UK, raising generalizability concerns.

Conclusions:

• Strategies exist to improve outpatient appointment attendance and reduce DNA rates.
• Future initiatives require careful piloting alongside rigorous evaluation frameworks to ensure effectiveness and equity.