The Role of Appointment Reminder Systems in improving appointment attendance among Patients: An Updated Systematic Review

Abstract

Reducing Did Not Attend (DNA) rates to scheduled appointments in a clinical setting is essential because it causes unnecessary delays among patients seeking treatment and places a constraint on valuable physician time and healthcare resources. Therefore, it is important for policy makers to budget resources and allocate to technologies that facilitate appointment reminders, thereby reducing appointment rescheduling and cancellations. A comprehensive literature search was carried out in Ovid Medline, Embase, Web of science databases, and research gate. The research was conducted in January 2021. The inclusion was studies from 2013 to date, cohort studies, cross-sectional studies, and randomized-control trials, all research designs, and studies which investigated the outpatient appointment reminders. The study excluded tutorials, editorials, conference abstracts, case reports and textbooks, studies that were not directly related to healthcare, studies that do not measure the effect of reminder systems, and non-empirical research. In terms of results, 2052 articles were found before the inclusion criteria was applied. Eleven (11) articles were found eligible, and data was synthesized from these high-quality studies. The Joanna Briggs Institute (JBI) tool was used to assess the quality of articles. The findings show that forgetting appointment date and falling very ill were the most common reasons for missing appointments. Patients’ failure to reschedule appointments to a suitable time was also a contributing factor. It was identified that using a “reminder plus” system was the most optimal solution in reducing DNA rates under most circumstances, as patients would be able to modify their appointments in a more convenient way, thereby reducing the likelihood of non-attendance. Receiving multiple SMS reminders prior to the scheduled appointment was the most preferred option among patients, as it is effective and convenient. The systematic review concludes that reminder systems are effective in increasing attendance for scheduled appointments and avoiding the negative effects of non-attendance. Reminder plus systems that provide more information than simple reminders are the most effective; three reminders prior to the appointment are more effective and present a potential solution to non-attendance. Understanding the nuanced barriers that prevent patients from fully utilising reminder systems is necessary to further improve effectiveness of reminder systems.