Using Mobile Phone Short Message Service (SMS) Reminders to Enhance Appointment Attendance in DM Patients

Using Mobile Phone Short Message Service (SMS) Reminders to Enhance Type 2 Diabetes Mellitus Appointment Attendance in a Primary Care Clinic

A randomized controlled trial of patients with type 2 diabetes mellitus with multiple appointments into short message service group and control group. The attendance rate of these two groups of patients will be compared.

The main objective of this study is to evaluate the appointment attendance rate using SMS reminder of nurses and allied health appointments for diabetic patients, when compared to conventional telephone reminder and no reminder. We also aim at determine the factors associated with appointment attendance. Finally, we will also survey patients' acceptance and satisfaction to the SMS service.

This is a single blind randomization study. It will be carried out in Ha Kwai Chung General Outpatient Clinic.

The primary outcome of this study is to evaluate the attendance rate of each individual doctor, nurses and allied health clinic appointments for diabetic patients, as well as their overall attendance rates:

1. Diabetes Complication Screening Clinic (OPAS DMCS/RDNA)
2. Diabetes Nurse Intervention Clinic (OPAS DMIC/RDNI)
3. DM nurse group (OPAS RDNG)
4. Dietitian Counselling (OPAS DC/DG)
5. Physiotherapy (OPAS PTC/PTG)
6. Diabetes Doctor Session (OPAS RDR)
7. Retino photo Assessment (OPAS RDO)
8. Blood taking appointment (OPAS LABT)

The secondary outcomes are:

• Acceptance Rate of SMS Reminder Vs Telephone Reminder Vs no reminder

• Factors associated with acceptance of SMS

  1. Personal Parameters: Age, sex, educational level, occupation, mobile phone models, Habit of using mobile phone service
  2. Disease Parameters: Number and types of comorbidity, disease control (by biochemical markers)
  3. Quality of Life (by SF-6D)

• Reported adverse effects of the reminder system

• Chang in biochemical markers (BMI, HbA1c, LDL-c level) 6-9 months later

Subjects who agreed to participate in this study will first receive a survey on the acceptance of SMS service. For those agree to receive SMS reminder, they will be randomized to:

1. an SMS remind them to come for scheduled clinic appointment 24-72 hours before, or
2. usual care with no reminder / telephone reminder.

Inclusion Criteria:

• With diagnosis of type 2 diabetes

• Have more than 1 clinic services appointment under RAMP-DM programme:

  (e.g. blood taking, diabetic nurse individual counselling, group education, diabetic complication screening, retinal photo assessment, dietician counselling, etc)

Exclusion Criteria:

1. Cannot read or receive appointment schedule on mobile phone
2. Do not speak Cantonese/English or read Chinese/English
3. Mentally incapacitated
4. Pregnant Women