Encouraging attendance at outpatient appointments: can we do more?

Non-attendance at new outpatient appointments is a challenge for health services. Patients with treatable morbidity may fail to receive care from which they would benefit, and scarce resources are wasted. Therefore, a literature review was undertaken to assess the effectiveness of appointment reminders as a means of increasing attendance and reducing 'Did not Attend' rates at new outpatient appointments.

Electronic databases were interrogated using a combination of MeSH terms and truncated keywords. In addition, the reference lists of papers were studied to identify additional relevant material.

Telephone and postal reminders appear effective, particularly if received within a day of scheduled appointments. Postal reminders offering a reward for attendance, threatening sanctions for non-attendance, and providing information about the clinic appear more effective than standard reminders. No studies assessing the impact of measures including e-mail or text messaging were identified. Many studies were conducted in psychiatric settings outwith the United Kingdom raising issues of generalisability. In addition, no assessment of how initiatives impact on inequalities in service access were found.

There is scope to increase attendance and reduce non-attendance at outpatient appointments but initiatives should be piloted in conjunction with robust evaluative frameworks.