N/A
N=80,389
Using Behavioral Economics to Enhance Appointment Reminders and Reduce Missed Visits
Appointment Reminders
Bottom Line
View on ClinicalTrials.gov: NCT03850431 ↗Enrolled (actual)
80,389
Serious AEs
0.0%
Results posted
Apr 2024
Primary outcome: Primary: No-Show Rate — 11.9; 11.1; 10.5; 12.1 percentage of appointments no showed — p=0.145
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Social Norms + Behavioral Instructions (Behavioral); Caring + Consequences for Others + Behavioral Instructions (Behavioral); Caring + Consequences for Self + Behavioral Instructions (Behavioral); Caring + Consequences for Others + Consequences for Self + Social Norms + Behavioral Instructions (Behavioral)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- VA Office of Research and Development
- Primary completion
- Oct 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY No-Show Rate |
11.9; 11.1; 10.5; 12.1; 10.6; 11.1 | 0.145 |
| SECONDARY Cancellation Rate |
6.0; 5.7; 8.9; 6.8; 8.5; 7.3 | 0.153 |
Summary
"No-shows," or missed visits are a persistent problem in all health care systems. They contribute to worsened patient access, longer wait times, and inefficient use limited health care resources. The VA's no-show rate has shown no improvement in years, resulting in a staggering 9 million ambulatory no-shows in Fiscal Year (FY) 2015. Appointment reminders are an essential and proven element to addressing no-shows but major research gaps exist. Behavioral economics (BE) and allied fields offer key insights that are relevant to developing innovation in the field of appointment reminders. Adding "nudges" informed by concepts such as social norms, behavioral intentions, clear instructions, and potential negative consequences to the Veteran and others is a novel but evidence-based way to create enhanced appointment reminders. Seemingly small changes to appointment letters can create measurable shifts in appointment attendance and no-shows. Even more, these behavioral nudges can produce large benefits when taken to scale and compounded across a population.
This project will address several aims, including: developing BE-informed messages to incorporate into enhanced appointment reminders; evaluating the effect of several versions of enhanced appointment reminders; and identifying potential barriers and facilitators to widespread implementation of enhanced appointment reminder messages.
Eligibility Criteria
Inclusion Criteria
- All subjects will be a minimum of 18 years old.
- All subjects will be patients with scheduled outpatient appointments (either primary care or mental health) in the VA Portland Health Care System.
- Race and ethnicity will not be used in determining inclusion or exclusion of subjects.
Exclusion Criteria
- None
Data sourced from ClinicalTrials.gov (NCT03850431). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.