Barriers to using text message appointment reminders in an HIV clinic

Area of Science:

• Public Health
• Infectious Diseases
• Health Services Research

Background:

• Appointment no-shows among persons with human immunodeficiency virus (HIV) are linked to adverse health outcomes.
• Text message appointment reminders are a potential intervention to improve attendance.
• The feasibility of text message reminders for persons with HIV in the U.S. remains unestablished.

Purpose of the Study:

• To assess the feasibility and impact of text message appointment reminders on clinic attendance for persons with HIV.
• To identify barriers to enrollment in a text message reminder study.

Main Methods:

• A randomized controlled trial was conducted in a large HIV clinic.
• Patients were randomized to receive text message reminders or standard care.
• Reasons for declining participation were collected, alongside demographic and clinical data.

Main Results:

• 45% of screened patients declined participation, citing lack of cell phone/text service, cost, comfort, and privacy concerns.
• Among those randomized, 24% had phones disconnected before the reminder date.
• No significant difference in clinic attendance rates was observed between the text reminder group and the control group (72% vs. 81%, p=0.42).

Conclusions:

• Significant barriers exist for implementing text message appointment reminders universally among persons with HIV.
• Addressing issues such as cell phone access and cost is crucial before widespread adoption.
• Text message reminders may be effective for specific patient subgroups, but not as a one-size-fits-all solution.