title: The use of text messaging to improve attendance in primary care: a randomized controlled trial.
abstract: BACKGROUND
  Non-attendance is common in primary care and previous studies have reported that reminders were useful in reducing broken appointments.
  
  
  OBJECTIVE
  To determine the effectiveness of a text messaging reminder in improving attendance in primary care.
  
  
  METHODS
  Multicentre three-arm randomized controlled trial.
  
  
  METHODS
  Seven primary care clinics in Malaysia. Participants. Patients (or their caregivers) who required follow-up at the clinics between 48 hours and 3 months from the recruitment date. Interventions. Two intervention arms consisted of text messaging and mobile phone reminders 24-48 hours prior to scheduled appointments. Control group did not receive any intervention. Outcome measures. Attendance rates and costs of interventions.
  
  
  RESULTS
  A total of 993 participants were eligible for analysis. Attendance rates of control, text messaging and mobile phone reminder groups were 48.1, 59.0 and 59.6%, respectively. The attendance rate of the text messaging reminder group was significantly higher compared with that of the control group (odds ratio 1.59, 95% confidence interval 1.17 to 2.17, P = 0.005). There was no statistically significant difference in attendance rates between text messaging and mobile phone reminder groups. The cost of text messaging reminder (RM 0.45 per attendance) was lower than mobile phone reminder (RM 0.82 per attendance).
  
  
  CONCLUSIONS
  Text messaging reminder system was effective in improving attendance rate in primary care. It was more cost-effective compared with the mobile phone reminder.
authors.affiliation: Department of Family Medicine, International Medical University Puchong, Jalan Rasah, Malaysia. leongk@pc.jaring.my
authors.forename: Kwok Chi
authors.initials: KC
authors.lastname: Leong
authors.forename: Wei Seng
authors.initials: WS
authors.lastname: Chen
authors.forename: Kok Weng
authors.initials: KW
authors.lastname: Leong
authors.forename: Ismail
authors.initials: I
authors.lastname: Mastura
authors.forename: Omar
authors.initials: O
authors.lastname: Mimi
authors.forename: Mohd Amin
authors.initials: MA
authors.lastname: Sheikh
authors.forename: Abu Hassan
authors.initials: AH
authors.lastname: Zailinawati
authors.forename: Chirk Jenn
authors.initials: CJ
authors.lastname: Ng
authors.forename: Kai Lit
authors.initials: KL
authors.lastname: Phua
authors.forename: Cheong Lieng
authors.initials: CL
authors.lastname: Teng
mesh_terms: D000328:Adult; D001071:Appointments and Schedules; D040421:Cell Phone / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008296:Malaysia; D008297:Male; D010358:Patient Participation; D011320:Primary Health Care / Q000379:methods; D017010:Reminder Systems / Q000191:economics; D012107:Research Design; D013685:Telecommunications / Q000191:economics