The project will be done at the ear, nose and throat outpatient department at Lovisenberg Diakonale Hospital (LDS) in 2015-2016. About 12% of patients with appointments at the surgical outpatient clinic at LDS do not attend their appointment even after receiving both letters and shot message service (SMS) reminders. Persuasion theory suggests that the SMS reminders may be more effective if the text appeals more to the patient's feelings. The project is designed as a randomized controlled trial in which the control group receives the standard text that has neutral content and the intervention group receives a more emotion-based SMS reminder. The aim is to determine whether the more emotional text reduces the proportion of patients who do not show up for their scheduled appointment at the surgical outpatient clinic.

Studies from Norway's Health South East (HSØ) show that the number of patients who do not attend their scheduled appointments account for 200 000 to 250 000 outpatient consultations each year. For comparison, there are 270,000 patients waiting for treatment. It has thus been recommended that regional health authorities take measures to reduce the number of patients who do not attend their scheduled appointment.

This study will evaluate whether short message service (SMS) appointment reminders that appeal to the patient's emotions are more effective for reducing non-attendance to scheduled outpatient appointments at the ear, nose, and throat outpatient clinic at Lovisenberg Diakonale Hospital in Oslo, Norway. The study will be designed as randomized controlled trial in which 2000 patients are randomly assigned to either the intervention group (emotional SMS text) or the control group (standard SMS text with neutral content). Because theory suggests that emotion-based text messages will be more effective reminders, it is hypothesized that they will result in a 50% reduction in the number of patients who do not show for their appointment compared to the control group.

Inclusion Criteria:

• Patients (any diagnosis) with a scheduled clinic appointment at the LDS Ear, Nose and Throat Surgical Clinic or scheduled for polysomnography during the inclusion period.
• Date of birth on or after 01.01.1935

Exclusion Criteria:

• Patients with 2 appointments on the same day, only the first appointment will be included.
• Patients without a phone number
• Patients born before 01.01.1935
• Included patients will not be included again if they get a new appointment in the inclusion period.