Caring + Consequences for Others + Consequences for Self + Social Norms + Behavioral Instructions for Appointment Reminders

Phase-Based Progress Estimates
1
Effectiveness
1
Safety
VA Portland Health Care System, Portland, OR, Portland, OR
Appointment Reminders
Caring + Consequences for Others + Consequences for Self + Social Norms + Behavioral Instructions - Behavioral
Eligibility
18+
All Sexes
Eligible conditions
Select

Study Summary

Using Behavioral Economics to Enhance Appointment Reminders and Reduce Missed Visits

See full description

Treatment Effectiveness

Effectiveness Estimate

1 of 3

Study Objectives

This trial is evaluating whether Caring + Consequences for Others + Consequences for Self + Social Norms + Behavioral Instructions will improve 1 primary outcome and 1 secondary outcome in patients with Appointment Reminders. Measurement will happen over the course of 1 year.

1 year
Cancellation Rate
No-Show Rate

Trial Safety

Safety Estimate

1 of 3

Trial Design

5 Treatment Groups

Usual Care
1 of 5
Caring + Consequences for Others + Behavioral Instructions
1 of 5
Combination of all Nudges
1 of 5
Caring + Consequences for Self + Behavioral Instructions
1 of 5
Social Norms + Behavioral Instructions
1 of 5
Active Control
Experimental Treatment

This trial requires 34516 total participants across 5 different treatment groups

This trial involves 5 different treatments. Caring + Consequences For Others + Consequences For Self + Social Norms + Behavioral Instructions is the primary treatment being studied. Participants will be divided into 4 treatment groups. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

Caring + Consequences for Others + Behavioral Instructions
Behavioral
A letter with three types of nudges. One suggests that the institution cares about the patient. One highlights a potential negative consequence for others if the patient no-shows. And one provides clear, specific instructions for making appointment changes. The appointment reminder also includes usual care (basic appointment information on date, location, and phone number(s) for scheduling changes).
Combination of all Nudges
Behavioral
A letter with all four types of nudges combined. One suggests that the institution cares about the patients. One highlights a potential negative consequence for others if the patient no-shows. One highlights potential negative consequences for the patient if s/he no-shows. One points out the common behavior of attending appointments. And one provides clear, specific instructions for making appointment changes. The appointment reminder also includes usual care (basic appointment information on date, location, and phone number(s) for scheduling changes).
Caring + Consequences for Self + Behavioral Instructions
Behavioral
A letter with three types of nudges. One suggests that the institution cares about the patients. One highlights potential negative consequences for the patient if s/he no-shows. And one provides clear, specific instructions for making appointment changes. The appointment reminder also includes usual care (basic appointment information on date, location, and phone number(s) for scheduling changes).
Social Norms + Behavioral Instructions
Behavioral
A letter with two types of nudges. One points out the common behavior of attending appointments. And one provides clear, specific instructions for making appointment changes. The appointment reminder also includes usual care (basic appointment information on date, location, and phone number(s) for scheduling changes).
Usual CareAn appointment reminder that includes basic appointment information on date, location, and phone number(s) for scheduling changes.

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: 1 year
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly 1 year for reporting.

Closest Location

VA Portland Health Care System, Portland, OR - Portland, OR

Eligibility Criteria

This trial is for patients born any sex aged 18 and older. There are 3 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
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.

Patient Q&A Section

What is appointment reminders?

"Patients who received reminders had a non-significant trend to healthier lifestyles, in the form of more exercise and smoking cessation. This is of potential implication to clinical practice." - Anonymous Online Contributor

Unverified Answer

What are common treatments for appointment reminders?

"The effectiveness and feasibility of appointment reminders is well established. The majority of surveyed patients who received their appointments in the last 30 days stated receiving their first appointment reminder had helped delay their next appointment or made them come in for the appointment sooner. Of all the patients surveyed, 81% (93) reported a noticeable difference in waiting to see their physician as a result of receiving the reminder. The use of email for notification of appointments was also effective at retaining patients in practice." - Anonymous Online Contributor

Unverified Answer

What causes appointment reminders?

"The reminder sent to correct nonarrivals in a GP appointment is an example of an electronic reminder. Electronic reminder systems have many potential applications, and may be especially effective when used for nonarrivals. An electronic reminder for a GP appointment may be beneficial by detecting and correcting the problem of missing appointments at an earlier stage in the process than would be the case with a paper reminder. However, further studies are needed to assess more quantitatively the impact of computerised reminders on attendance, as well as the practicality and cost effectiveness of using a computerised reminder to correct nonarrivals in routine practice." - Anonymous Online Contributor

Unverified Answer

Can appointment reminders be cured?

"The efficacy and benefits of appointment reminders with a reminder system that incorporates electronic mail and e-mail reminders can be improved by the addition of scheduling reminders, which in turn may help patients comply with health recommendations." - Anonymous Online Contributor

Unverified Answer

How many people get appointment reminders a year in the United States?

"The U.S. National Institute of Neurological Disorders and Stroke says that each year 3.5 million people are affected by Parkinson's disease, with 1.5 million people receiving levodopa/carbidopa every year. By the same token, 683,000 people will have at least one outpatient emergency department visit for a headache or migraine that is not controlled by prescription medication. The following estimate includes everyone in the U.S. and everyone in Canada. It is conceivable that other numbers are a bit higher or lower. For example, we assume that 30% of people with epilepsy have severe, uncontrolled seizures." - Anonymous Online Contributor

Unverified Answer

What are the signs of appointment reminders?

"This is probably the first study to systematically compare the patient and physician features of patients who received appointment reminders. We found that patients' primary concerns about their illness, their willingness to be seen by their doctor are likely to be the major factors determining whether patients prefer to receive or not receive reminders. Data from a recent study suggest the need for personalized patient-centered counseling when designing reminders." - Anonymous Online Contributor

Unverified Answer

What is caring + consequences for others + consequences for self + social norms + behavioral instructions?

"With the development of care interventions and care delivery systems, CCS should be a key aspect of the provision of care for both patients and their carers. As for carers in particular, the value of CCS should be understood in terms of its consequences for individuals, health-care systems and society." - Anonymous Online Contributor

Unverified Answer

Have there been other clinical trials involving caring + consequences for others + consequences for self + social norms + behavioral instructions?

"Although our study results may appear to be negative, they indicate that it is important to look for other potential treatments for caring before deciding on the best treatment for caring." - Anonymous Online Contributor

Unverified Answer

How serious can appointment reminders be?

"In this longitudinal study, both the number and content of appointment reminders had no adverse effects on the clinical care of the study population. In an effort to minimize the risks of reminder fatigue, clinical practice guidelines should emphasize the importance and benefits of reminder systems." - Anonymous Online Contributor

Unverified Answer

Is caring + consequences for others + consequences for self + social norms + behavioral instructions safe for people?

"Considered in conjunction with a person's characteristics (ie, age and characteristics/behavioral context in which social norms unfold), consequences for peers and others are not universally advantageous, and effects on self are less predictable. Interventions that target these individual traits may be more successful, but interventions based on social norms, as found in this study, may still offer benefit." - Anonymous Online Contributor

Unverified Answer

What are the common side effects of caring + consequences for others + consequences for self + social norms + behavioral instructions?

"Results from a recent clinical trial reveals a wide variety of responses of social norms for common and potential consequences for others, possible consequences for self, and behavioral instructions when responding to a hypothetical patient. This research should help physicians, patients, and caregivers better understand people’s decisions and response choices over time and across contexts, so that physicians and providers can inform patients of their preferences over time and space and thus modify treatment plans as needed." - Anonymous Online Contributor

Unverified Answer

Have there been any new discoveries for treating appointment reminders?

"In [Appointment reminders], physicians are encouraged to use new treatments. To better treat patients, physicians will take advantage of new treatments. Also, the appointment reminder system should be adjusted to better take care of patients' interests in receiving treatment." - Anonymous Online Contributor

Unverified Answer
Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.
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