A Phone Reminder System to Improve Adherence to Long-Acting Injectable Medications.

Abstract

Problem & Purpose: A small, outpatient mental health clinic (OMHC) identified poor attendance for patients receiving a long-acting injectable (LAI) on a walk-in basis. Site data reviewed for August and September 2022 identified an average 20% “no show” rate with some weeks as high as 46%. Current literature has shown that missed appointments contribute to poorer patient outcomes and an increase in morbidity and mortality. Purpose: The purpose of this project was to implement and evaluate the effectiveness of electronic appointment reminders for long-acting injectable appointments in an OMHC. Methods: Implementation was from September 4, 2023, to December 11, 2023. An electronic reminder, text or phone call based on client preference, was sent to all clients due for an injection in addition to pre-existing reminder cards. A list was generated weekly by the injection nurse identifying those who were due for injections and sent to front desk staff to send out reminders. The nurse asked the clients if they received the reminder and recorded this information in a survey in a secure, HIPAA protected database (REDCap) using a secure URL. Data collected included the number of individuals due for an injection that week, those who received their electronic reminders, those who did not receive their reminders, and those who attended. Results: Data collected showed approximately 50% (n=21) of clients did not receive the reminder, despite 100% of clients being sent an electronic reminder. An average of 80% (n=21) of clients attended each week for their LAI. Electronic reminders may not have been received due to incorrect contact information or difficulty reaching group home residents. Conclusions: Reminders were more useful for outpatient clients than group-home residents, as group home residents were less likely to have a dedicated phone line or email.