Optimizing number and timing of appointment reminders: a randomized trial

Area of Science:

• Health Services Research
• Patient Engagement
• Healthcare Management

Background:

• Missed appointments in primary care lead to significant healthcare inefficiencies and costs.
• Optimizing appointment reminder strategies is crucial for improving healthcare access and resource allocation.

Purpose of the Study:

• To evaluate the effectiveness of different automated appointment reminder schedules on reducing missed primary care appointments.
• To assess the impact of reminder frequency on patient visit satisfaction.

Main Methods:

• A three-armed randomized controlled trial involving 54,066 patients across 25 primary care clinics.
• Patients received either a 3-day reminder, a 1-day reminder, or both 3-day and 1-day reminders via text message or interactive voice response.
• A predictive model was developed to identify high-risk patients for missed appointments.

Main Results:

• The group receiving two reminders (3 days and 1 day prior) had a lower missed appointment rate (4.4%) compared to single reminders (5.8% for 3-day, 5.3% for 1-day; P <.001).
• For high-risk patients, two reminders reduced missed visits to 20.5% versus 25.0% and 24.2% for single reminders (P <.001).
• Patient visit satisfaction remained unaffected by the number of reminders received.

Conclusions:

• Utilizing two automated appointment reminders is more effective than one in decreasing missed appointments without compromising patient satisfaction.
• A predictive model effectively identifies high-risk patients who may benefit most from multiple reminders.
• Further strategies are needed to further reduce missed appointment rates, particularly among high-risk populations.