Mobile phone messaging reminders for attendance at healthcare appointments

Ipek Gurol‐Urganci; Thyra de Jongh; Vlasta Vodopivec‐Jamsek; Rifat Atun; Josip Car

doi:10.1002/14651858.CD007458.pub3

Cochrane Database of Systematic Reviews

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DOI:

https://doi.org/10.1002/14651858.CD007458.pub3 Copiar DOI

Base de datos:

Cochrane Database of Systematic Reviews

Versión publicada:

05 diciembre 2013see what's new

Tipo:

Intervention

Etapa:

Review

Grupo Editorial Cochrane:

Grupo Cochrane de Consumidores y comunicación

Copyright:

Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Contraer

Autores

Ipek Gurol‐Urganci

Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
Thyra de Jongh

Gephyra IHC, Amsterdam, Netherlands
Vlasta Vodopivec‐Jamsek

Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Rifat Atun

Imperial College Business School, Imperial College London, London, UK
Josip Car

Correspondencia a: Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

[email protected]

Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK

Contributions of authors

Ipek Gurol‐Urganci developed the protocols and was involved in both the original version of this review and the 2013 update. She has led the updated search process and participated in screening the papers. She collected, analysed, interpreted the data and participated in writing the review.

Thyra de Jongh was involved in the original version of this review and has led the 2013 update. This includes the screening and quality appraisal processes for the studies, as well as the data extraction and management. She has collected, analysed and interpreted the data and participated in writing the review.

Vlasta Vodopivec Jamsek helped develop the protocols. For the 2013 update of this review she has been involved in data extraction and has contributed to writing the review.

Rifat Atun provided strategic guidance in all stages of the study and contributed to writing of the review.

Josip Car conceived the review together with Rifat Atun and has played a coordinating role in all stages of the study. He contributed to writing the review.

Sources of support

Internal sources

eHealth Unit, Department of Primary Care and Social Medicine, Imperial College, UK.

salaries, office space
Centre for Health Management, Tanaka Business School, Imperial College, UK.

salaries, office space
Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Slovenia.

salaries, office space
London School of Hygiene and Tropical Medicine, UK.

salaries, office space

External sources

No sources of support supplied

Declarations of interest

None known.

Acknowledgements

We acknowledge the very helpful support of the Cochrane Consumers and Communication Review Group editorial base in different stages of this review.

Version history

Published

Title

Stage

Authors

Version

2013 Dec 05

Mobile phone messaging reminders for attendance at healthcare appointments

Review

Ipek Gurol‐Urganci, Thyra de Jongh, Vlasta Vodopivec‐Jamsek, Rifat Atun, Josip Car

https://doi.org/10.1002/14651858.CD007458.pub3

2012 Jul 11

Mobile phone messaging reminders for attendance at healthcare appointments

Review

Josip Car, Ipek Gurol‐Urganci, Thyra de Jongh, Vlasta Vodopivec‐Jamsek, Rifat Atun

https://doi.org/10.1002/14651858.CD007458.pub2

2008 Oct 08

Mobile phone messaging reminders for attendance at scheduled healthcare appointments

Protocol

Josip Car, Ipek Gurol‐Urganci, Thyra de Jongh, Vlasta Vodopivec‐Jamsek, Rifat Atun

https://doi.org/10.1002/14651858.CD007458

Differences between protocol and review

Changes between the protocol (Car 2008b) and the original review (Car 2012):

We were not able to search the following databases we had listed in the protocol (Car 2008b):

Proceedings from the MEDNET Congresses: We could not access the proceedings.
TrialsCentralTM (www.trialscentral.org): The website for the database was not functional and did not allow for the search of clinical trials.
African Trials Register: The trials in the African Trials Register are collected with a search strategy using the Cochrane Controlled Trials Register and the African Health Anthology (AHA). As we searched both original sources, it was not necessary to access the African Trials Register separately.
Health Star: The database ceased to exist as of December 2000, with all peer‐reviewed journal articles transferred to PubMed.

Changes between the original (Car 2012) and the updated review:

Compared to the first version of this review (Car 2012) several changes have been made to the methodology. These changes were approved by the editors of the Cochrane Consumers and Communication Review Group before the update was conducted. Specifically, we have made the following changes:

We excluded the LILACS and African Health Anthology databases from our search, as these proved very difficult to search and produced no studies of interest to the initial review that were not also retrieved from other, included databases;
We no longer included the following study designs: quasi‐randomised controlled trials (QRCTs), controlled before and after studies (CBAs), and interrupted time series (ITS) with at least three time points before and after the intervention, because the original review found no such studies that met the criteria for inclusion;
We reorganised the data extraction sheet to group specific data under different headings, but maintaining all relevant fields, to enable a better overview;
We no longer aimed to conduct subgroup analysis for different age categories as the original review indicated that very few studies stratified outcomes by age;
We no longer aimed to conduct sensitivity analysis to check for the effects of publication language or source of funding as the original review found only a few studies published in languages other than English and source of funding did not appear to be relevant factor;
In the original review, study results were not combined in a meta‐analysis if there was substantial clinical, methodological or statistical heterogeneity. In the updated review, however, we have conducted a meta‐analysis of all combined results, despite significant statistical heterogeneity. Instead, we have addressed the issue of heterogeneity by also performing a sensitivity analysis of the results, with exclusion of the outlying study.

Keywords

MeSH

Medical Subject Headings (MeSH) Keywords

Medical Subject Headings Check Words

Humans;

PICO

Population

Intervention

Comparison

Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Figure 1

Study flow diagram. (Note: search strategy and screening selection is common for this review and for de Jongh in preparation until the final allocation stage).

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Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Figure 3

Forest plot of comparison: 1 Mobile phone text message reminders vs no reminders, outcome: 1.1 Attendance rate at healthcare appointments.

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Figure 4

Forest plot of comparison: 2 Mobile phone message text reminders plus postal reminders vs postal reminders, outcome: 2.1 attendance rate of scheduled healthcare appointments.

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Figure 5

Forest plot of comparison: 3 Mobile phone message reminders vs phone call reminders, outcome: 3.1 Attendance rate at healthcare appointments.

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Analysis 1.1

Comparison 1 Mobile phone text message reminders vs no reminders, Outcome 1 Attendance rate at healthcare appointments.

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Analysis 1.2

Comparison 1 Mobile phone text message reminders vs no reminders, Outcome 2 Attendance rate at healthcare appointments (sensitivity analysis).

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Analysis 2.1

Comparison 2 Mobile phone message text reminders plus postal reminders vs postal reminders, Outcome 1 Attendance rate at healthcare appointments.

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Analysis 3.1

Comparison 3 Mobile phone message reminders vs phone call reminders, Outcome 1 Attendance rate at healthcare appointments.

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Summary of findings for the main comparison. Mobile phone text message reminders compared to no reminders for patients with scheduled healthcare appointments

Patient or population: Patients with healthcare appointments Settings: All settings (primary, hospital, community, outpatient) Intervention: Mobile phone text message reminders Comparison: No reminders
Outcomes	*Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No of Participants (studies)	Quality of the evidence (GRADE)
	Assumed risk	Corresponding risk
	No reminders	Mobile phone text message reminders
Attendance rate at healthcare appointments	678 per 1000	773 per 1000 (698 to 854)	RR 1.14 (1.03 to 1.26)	5841 (7 studies)	⊕⊕⊕⊝ moderate^a,b
Other outcomes	None of the included studies reported on health outcomes, costs, user evaluation of the intervention, user perception of safety, potential harms or adverse effects of the intervention.
The basis for the assumed risk* (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio;
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
^a Unclear risk of bias for several categories in the included studies. ^b In one study the unit of analysis was appointment rather than the individual participant which may have resulted in clustering of data.

Summary of findings for the main comparison. Mobile phone text message reminders compared to no reminders for patients with scheduled healthcare appointments

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Summary of findings 2. Mobile phone message text reminders plus postal reminders compared to postal reminders alone for patients with scheduled healthcare appointments

Patient or population: Patients with healthcare appointments Settings: All settings (primary, hospital, community, outpatient) Intervention: Mobile phone message text plus postal reminders Comparison: Postal reminders
Outcomes	*Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No of Participants (studies)	Quality of the evidence (GRADE)
	Assumed risk	Corresponding risk
	Postal reminders	Mobile phone message text plus postal reminders
Attendance rate at healthcare appointments	858 per 1000	944 per 1000 (875 to 1000)	RR 1.10 (1.02 to 1.19)	291 (1 study)	⊕⊕⊝⊝ low^a
Other outcomes	The included study did not report on health outcomes, costs, user evaluation of the intervention, user perception of safety, potential harms or adverse effects of the intervention.
The basis for the assumed risk* (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio;
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
^aOnly one study included, with small number or participants. No information provided about the method of randomisation, allocation concealment, blinding and selective outcome reporting (unclear risk of bias). Low risk only for attrition bias.

Summary of findings 2. Mobile phone message text reminders plus postal reminders compared to postal reminders alone for patients with scheduled healthcare appointments

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Summary of findings 3. Mobile phone message reminders compared to phone call reminders for patients with scheduled healthcare appointments

Mobile phone message reminders compared to phone call reminders for patients with healthcare appointments
Patient or population: patients with healthcare appointments Settings: all settings (primary, hospital, community, outpatient) Intervention: Mobile phone message reminders Comparison: phone call reminders
Outcomes	*Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No of Participants (studies)	Quality of the evidence (GRADE)
	Assumed risk	Corresponding risk
	Phone call reminders	Mobile phone message reminders
Attendance rate at healthcare appointments	803 per 1000	795 per 1000 (763 to 819)	RR 0.99 (0.95 to 1.02)	2509 (3 studies)	⊕⊕⊕⊝ moderate^a,b
Costs	While the attendance rates after text messages versus phone reminders were similar, the costs per text message per attendance were 55% and 65% lower than costs per phone call reminder in two included studies.
Adverse outcomes	One study reported that there were no adverse events during the study period. Two studies did not report on adverse events.
Other outcomes	None of the included studies reported on health outcomes, user evaluation of the intervention or user perception of safety.
The basis for the assumed risk* (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio;
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
^a Unclear risk of bias for several categories in the included studies. ^b In one study the unit of analysis was appointment rather than the individual participant which may have resulted in clustering of data.

Summary of findings 3. Mobile phone message reminders compared to phone call reminders for patients with scheduled healthcare appointments

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Table 1. Characteristics of communication modes

	Face‐to‐face	Postal Letter	Call to Landline	Call to Mobile	Web Based (Electronic Health Record)	Email	SMS / MMS
Immediacy	Slow: Requires a visit to the provider	Slow: around 2 days	Immediate, if person is at home. Return call may be necessary.	Immediate, if person answers (more likely than landline). Return call may be necessary.	Immediate	Immediate or stored	Immediate or stored
Privacy and Confidentiality	High: Personal communication	High: Personally addressed	Low: Confidentiality prevents message being left as others may answer or retrieve it.	High: Personal device enables possibility of message being left.	Moderate: dependent on whether device is personal or public.	Moderate: dependent on whether device is personal or public.	High, if personal device.
Likelihood of misinterpretation	Low	Moderate	Low, as patient can request immediate clarification	Low, as patient can request immediate clarification	Moderate	Moderate	Moderate
Delivery confirmation possible	Not applicable	Yes, but only at significant expense	Unnecessary if call is answered. No, if message was left.	Unnecessary if call is answered. No, if message was left.	Not applicable	Yes	Yes
Cost	High	Moderate	Low	Moderate	Low	Low	Low

Table 1. Characteristics of communication modes

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Table 2. Secondary outcomes data

Study	Costs and cost effectiveness (monetary unit as specified in the study)	Participant evaluation of the intervention (as reported in the study)	Potential harms or adverse effects of the intervention (as reported in the study)
Chen 2008	Cost per attendance: SMS group: 0.31 Yuan (4.7 GBP) Telephone group: 0.48 Yuan (7.3 GBP) Ratio of total cost per attendance: SMS group: 0.65 (relative to telephone group)	Not reported	Not reported
Koury 2005	Not reported	98% willing to receive routine reminders of their appointments. Usefulness of the intervention: 62% thought it would be useful 31% doubted its value 7% were unsure	Not reported
Leong 2006	Cost per attendance: SMS group: 0.45 RM (0.67 GBP) Mobile phone group: 0.82 RM (0.123 GBP) Ratio of total cost per attendance: SMS group: 0.55 (relative to mobile phone group)	Not reported	No adverse events reported during the study period.
Lin 2012	Not reported	132 out of 135 (97.8%) reported they would like the intervention to continue	Not reported

Table 2. Secondary outcomes data

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Comparison 1. Mobile phone text message reminders vs no reminders

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Attendance rate at healthcare appointments Show forest plot	7	5841	Risk Ratio (M‐H, Random, 95% CI)	1.14 [1.03, 1.26]

2 Attendance rate at healthcare appointments (sensitivity analysis) Show forest plot	6	4809	Risk Ratio (M‐H, Random, 95% CI)	1.08 [1.05, 1.12]

Comparison 1. Mobile phone text message reminders vs no reminders

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Comparison 2. Mobile phone message text reminders plus postal reminders vs postal reminders

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Attendance rate at healthcare appointments Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

Comparison 2. Mobile phone message text reminders plus postal reminders vs postal reminders

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Comparison 3. Mobile phone message reminders vs phone call reminders

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Attendance rate at healthcare appointments Show forest plot	3	2509	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.95, 1.02]

Comparison 3. Mobile phone message reminders vs phone call reminders

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