Background: High rates of missed appointments for routine HIV care are associated with unsuppressed viremia, increasing morbidity.
Local problem: The Clinic no-show rate ranged between 30% and 35%, and only 69% of patients were considered retained in care within a 24-month time frame.
Methods: The Woodward Risk Prediction Tool was completed on all patients to stratify patient risk for missing the next appointment.
Interventions: All patients were offered text message along with standard phone message appointment reminders, and patients who missed appointments were called within 24 hours to reschedule. Medium-risk patients received a previsit planning call to remove barriers to appointment attendance, and high-risk patients received a home visit from the peer navigator.
Results: The project resulted in a 3.8% reduction rate in the overall no-show rate in the first 5 months of implementation. Using risk stratification and targeted interventions allowed valuable resources to be allocated where they were needed.