Use of SMS text messaging to improve outpatient attendance

Sean R Downer, John G Meara and Annette C Da Costa
Med J Aust 2005; 183 (7): 366-368.


Objective: To evaluate the effect of appointment reminders sent as short message service (SMS) text messages to patients’ mobile telephones on attendance at outpatient clinics.

Design: Cohort study with historical control.

Setting: Royal Children’s Hospital, Melbourne, Victoria.

Patients: Patients who gave a mobile telephone contact number and were scheduled to attend any of five outpatient clinics (dermatology, gastroenterology, general medicine, paediatric dentistry and plastic surgery) in September (trial group) or August (control group), 2004.

Main outcome measures: Failure to attend (FTA) rate compared between the group sent a reminder and those who were not.

Results: 2151 patients were scheduled to attend a clinic in September; 1382 of these (64.2%) gave a mobile telephone contact number and were sent an SMS reminder (trial group). Corresponding numbers in the control group were 2276 scheduled to attend and 1482 (65.1%) who gave a mobile telephone number. The FTA rate for individual clinics was 12%–16% for the trial group, and 19%–39% for the control group. Overall FTA rate was significantly lower in the trial group than in the control group (14.2% v 23.4%; P < 0.001).

Conclusions: The observed reduction in failure to attend rate was in line with that found using traditional reminder methods. The ease with which large numbers of messages can be customised and sent by SMS text messaging, along with its availability and comparatively low cost, suggest it may be a suitable means of improving patient attendance.

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  • Sean R Downer1
  • John G Meara2
  • Annette C Da Costa3

  • Royal Children’s Hospital, Parkville, VIC.



We thank the Telstra Corporation Ltd for providing free SMS messages for the duration of the trial.

Competing interests:

Sean Downer and Annette Da Costa own shares in the Telstra Corporation.

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