JMIR Publications

ABSTRACT

Background:

The socio-political crisis in Haiti affects healthcare center attendance, creating significant challenges in ensuring patient compliance with medical appointments.

Objective:

We aimed to assess the effectiveness of text message reminders on patient attendance in the context of the socio-political crisis of Haiti, examining the influence of patient perceptions, behaviors, and socio-economic factors.

Methods:

We conducted a telephone survey of 386 randomly selected patients who had an appointment during the third quarter of 2024 at two healthcare centers in the Port-au-Prince metropolitan area. We collected appointment and socioeconomic data, as well as perceptions and behaviors toward text message reminders. We described patients' perceptions and behaviors toward text message reminders, as well as appointment attendance and patient characteristics. We performed bivariate and multivariate logistic regression models to assess whether receiving text message reminders and socioeconomic factors influenced overall appointment attendance.

Results:

Among 386 patients, 259 attended their appointments on either the appointment day or at a later date for an overall attendance rate of 67.1% (CI: 62.4%, 71.8%). Attendance rates were higher among the 147 patients who confirmed receiving a reminder (77.6%) compared to the 239 who did not (60.7%). SMS reading behavior varied among patients. Overall, 219 (56.7%) patients always, 66 (17.1%) often, 75 (19.4%) sometimes, 21 (5.4%) rarely, and 5 (1.3%) never read their SMS. All patient liked the initiative of sending reminders and found them helpful. In the multivariate analysis, patients who confirmed receiving a reminder were more likely to attend their appointment compared to those who did not (aOR: 2.0; CI: 1.18, 3.39). A patient satisfaction rate of 8 or higher with their physicians was significantly associated with higher attendance rates, compared to 6 or lower, with adjusted odds ratios increasing with satisfaction. Travel time less than 30 minutes (aOR: 2.31; CI: 1.03–5.19) and 30 to 60 minutes (aOR: 2.78; CI: 1.24–6.21), and being with a Chronic disease (aOR: 0.42; CI: 0.23, 0.79) were also associated appointment attendance.

Conclusions:

Our study highlights the potential of text message reminders to improve appointment attendance in Haiti, despite the socio-political crisis. The overall acceptability and positive perceptions of SMS reminders suggest that they can be a valuable tool in healthcare settings, especially when adapted to the local context.