Article Text

G200 Impact of altering text message reminders with persuasive messages on paediatric outpatient attendance at a tertiary children’s hospital
  1. TKW Ramcharan,
  2. S Pandya,
  3. J Cowling
  1. Birmingham Children’s Hospital, Birmingham, UK


Background Non-attendance to outpatient appointments results in loss of financial income and reduces the utilisation of clinics. Currently our trust sends automatic text message reminders to parents 7 days prior to the child’s appointment. A recent trial showed a reduction in “Did not attend” (DNA) rates in adult medicine by stating appointment costs in the text message reminder1.

Aim To conduct a trial to assess the impact of altering text message reminders to include a persuasive message, on DNA, cancellation and rescheduling rates at our hospital.

Methods In two paediatric specialties, we piloted three new text messages (Table 1), which were each sent for one week consecutively. At the end of the trial period the DNA, cancellation and rescheduling rates were compared between the three trial texts and original text message. Additionally, a written survey was conducted in the affected clinics to gain feedback on the text messages and assess their influence.

Abstract G200 Table 1

Text message reminders sent

Results 1378 text message reminders were sent during the three week trial, on average 460 texts per week. The DNA rate (Figure 1) for the original text was 9.1%, which dropped to 8.7% for text 1, 7.8% for text 2, and 8.3% for text 3. Cancellation and rescheduling rates showed a reduction of around 2% for each new text. From the survey, we received 58 responses, of which 48% felt the trial text made them more likely to attend the appointment. The main message preferred was text 3.

Abstract G200 Figure 1

Results of text message reminders on DNA, cancellation and rescheduling rates

Conclusion This study shows the impact that a simple cost-neutral change to the content of a text message reminder can have on outpatient attendance, with the most impressive being from including the cost of the appointment. Reduction in cancellation and rescheduling rates also suggests the change in text message made parents more likely to attend the given appointment, which was emphasised by the survey. The study also reinforces the role of text message reminders in improving outpatient attendance.


  1. Hallsworth M et al. Stating Appointment Costs in SMS Reminders Reduces Missed Hospital Appointments:Findings from Two Randomised Controlled Trials. PLOS ONE 2015;10(9):e0137306

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