Appointment reminder systems are effective but not optimal: results of a systematic review and evidence synthesis employing realist principles

MCLEAN, Sionnadh, BOOTH, Andrew, GEE, Melanie, SALWAY, Sarah, COBB, Mark, BHANBHRO, Sadiq and NANCARROW, Susan (2016). Appointment reminder systems are effective but not optimal: results of a systematic review and evidence synthesis employing realist principles. Patient Preference and Adherence, 10, 479-499.

McLean et al 2016 appointment-reminder-systems-are-effective-but-not-optimal--_040416.pdf - Published Version
Creative Commons Attribution Non-commercial.

Download (566kB) | Preview
Official URL:
Link to published version::
Related URLs:


Missed appointments are an avoidable cost and resource inefficiency which impact upon the health of the patient and treatment outcomes. Healthcare services are increasingly utilizing reminder systems to manage these negative effects. This study explores the effectiveness of reminder systems for promoting attendance, cancellations and rescheduling of appointments across all healthcare settings and for particular patient groups and the contextual factors which indicate that reminders are being employed sub-optimally. We used three inter-related reviews of quantitative and qualitative evidence. Firstly, using pre-existing models and theories, we developed a conceptual framework to inform our understanding of the Contexts and Mechanisms which influence reminder effectiveness. Secondly, we performed a review following Centre for Reviews & Dissemination (CRD) guidelines to investigate the effectiveness of different methods of reminding patients to attend health service appointments. Finally, to supplement the effectiveness information, we completed a review informed by realist principles to identify factors likely to influence non-attendance behaviors and the effectiveness of reminders. We found consistent evidence that all types of reminder systems are effective at improving appointment attendance across a range of health care settings and patient populations. Reminder systems may also increase cancellation and rescheduling of unwanted appointments. “Reminders plus”, which provide additional information beyond the reminder function, may be more effective than simple reminders at reducing non-attendance at appointments in particular circumstances. We identified six areas of inefficiency which indicate that reminder systems are being used sub-optimally. Unless otherwise indicated, all patients should receive a reminder to facilitate attendance at their healthcare appointment. The choice of reminder system should be tailored to the individual service. To optimize appointment and reminder systems, healthcare services need supportive administrative processes to enhance attendance, cancellation, rescheduling and re-allocation of appointments to other patients.

Item Type: Article
Research Institute, Centre or Group - Does NOT include content added after October 2018: Centre for Health and Social Care Research
Identification Number:
Page Range: 479-499
Depositing User: Sionnadh Mclean
Date Deposited: 29 Apr 2016 14:51
Last Modified: 18 Mar 2021 16:02

Actions (login required)

View Item View Item


Downloads per month over past year

View more statistics