The use of text messaging to improve attendance in internal medicine outpatient clinic: A randomized controlled trial in a teaching hospital in Saudi Arabia

All patients whose mobile number were documented in the hospital electronic database and were due to attend an appointment to the IM outpatient clinic during the following week were eligible to be included in the study. Because the SMS reminder messages will be sent in Arabic, non-Arabic speaking patients were excluded from the study. Patients younger than 18 years were also excluded. Each week a list of patients with appointment for the following week was retrieved from the hospital electronic database. A random sample of 20 patients was selected from the list of each day of the week. Using computer generated random number, these 20 patient appointments were then randomly allocated to either receive a reminder text message or to not receive such a reminder (10 appointments per group). This process continued over the study period (3 months) until the required sample size was collected. A standard text message reminder was sent manually to the intervention group using one of the phone service providers in Saudi Arabia 48 hours before the scheduled appointment. It started by a greeting at the beginning of the message followed by a reminder of the date, clinic name, and the hospital name. The text message did not has patient’s name. Within one week of the appointment, we conducted a telephone survey of a group of participants in the intervention group regarding their perception toward the SMS reminder. Other data collected from the electronic database included: patient age, sex, nationality, type of visit (new/follow-up) and whether the patient attended the scheduled appointment (show/no-show). The sequence of the randomization was concealed from the IT individual who provided the appointment list. The statistician was also blinded to the patient group.