Short message service (SMS) reminders improve treatment attendance in alcohol dependence, but are less effective for patients high in impulsivity

Abstract

Background and aimsPoor attendance increases the likelihood of relapse in alcohol dependence treatment. Evidence for improved attendance rates following introduction of short message service (SMS) appointment reminders is available in other health care domains. Patients high in impulsivity, characterized by a lack of planning, may particularly benefit from reminders. The study investigated the impact of SMS reminders on outpatient treatment attendance for alcohol dependence, and whether effects were moderated by impulsivity. DesignProspective natural history study, with historical case control. Alcohol-dependent outpatients attending treatment received SMS appointment reminders (n = 102). These were compared to a historical control group (n = 91) treated prior to the introduction of SMS (totalling 1149 scheduled sessions). SettingA metropolitan university hospital alcohol and drug outpatient clinic. Participants193 alcohol-dependent patients participated in a 12-week cognitive-behavioral therapy (CBT) program with a treatment goal of abstinence. MeasurementsTrait impulsivity, severity of dependence, psychological distress at baseline. Attendance at each scheduled session. FindingsSMS reminders significantly increased probability of session attendance (0.90 versus 0.84, p = .02). The effect was qualified by a significant SMS x Impulsivity interaction whereby reminders became less effective with increasing patient impulsivity (p = .003). ConclusionsSMS appointment reminders improve treatment attendance for alcohol-dependent outpatients. More impulsive patients benefited less from reminders, suggesting their non-attendance may be related more to motivational factors.