부산대학교 도서관

Introduction: Chronic non-communicable disease (NCD) care requires long-term compliance with clinic appointments. In rural Haiti, remembering appointments is a barrier to visit adherence. While short message service (SMS) text reminders can improve attendance in other settings, this has not been assessed Haiti. This quality improvement study assesses the feasibility and acceptability of using SMS reminders to promote clinic attendance in rural Haiti.Methods: We included patients at the NCD and type 1 diabetes clinics of Hôpital Universitaire de Mirebalais, Haiti. Patients with upcoming visits were sent 2 SMS reminders 3 days and 1 day before their visit. Patients who attended their clinic visit completed a survey regarding the feasibility, acceptability, and usefulness of the SMS reminders. The primary study outcome was the proportion of patients who received SMS messages. Secondary outcomes included the proportion of patients who found SMS reminders acceptable, missed clinic appointments, and could not be reached by phone.Results: Of the 96 patients with scheduled visits during the study period, we sent SMS reminders to 88 (91.2%) patients; 8 did not have recorded phone numbers. 25% of patients missed their visit and 9% were unable to be reached by phone. The 72 patients that attended their visit had a mean age of 49.5 years and 58.2% were female. Half of those who attended their visit (36) received the SMS. Of the 36 patients that received the SMS, 100% liked the reminder, 97.2% wanted to receive future messages, and 22.2% reported they would not have attended their visit without the reminder. Of the 36 patients who did not receive the SMS, 14 (38.9%) had a new phone number while 12 (33.3%) did not have access to a phone. The biggest patient-reported barriers to receiving SMS were inconsistent cellular signal (25%) and lack of access to a phone (22%).Conclusion: Sending SMS reminders was feasible and acceptable to NCD patients in rural Haiti. The messages were universally liked by the patients who received them and influenced the decision to attend their visit. For some patients, inconsistent signal and lack of phone access will need to be addressed. If implemented at full scale, SMS reminders could significantly improve appointment attendance in rural Haiti.