Patient SMS reminders for hospitals and clinics: a practical guide

A patient SMS is a short text message that a hospital, clinic, laboratory or health centre sends to its patients: an appointment reminder, a results notice, a vaccination date, a prescription running out. Patient SMS reminders have been tested in many trials, including in Africa, and they reduce missed appointments. In the DRC, where most people have no mobile internet, SMS also helps reach patients who are offline.

Why send SMS to patients?

Because forgetting is one of the main reasons for missed appointments, and an SMS works on every mobile phone, even without internet.

Healthcare SMS in the DRC: reaching patients without internet

At the end of March 2026, the DRC had 74,969,343 mobile subscriptions but only 38.2 million mobile internet subscriptions, according to the quarterly report of ARPTC, the telecoms regulator. About one line in two therefore has no mobile internet subscription: SMS still works without one, WhatsApp does not.

Do patient SMS reminders reduce no-shows?

Yes. SMS reminders increase attendance, with an effect similar to a phone call, at a lower cost.

The 2013 Cochrane review covers 8 trials and 6,615 participants: 78.6% of patients reminded by SMS attended, against 67.8% without a reminder and 80.3% after a phone call (moderate-quality evidence). In two studies, the cost per attended appointment was 55% and 65% lower than with a phone call.

In Cameroon, the MORE CARE trial (2014) followed 242 children exposed to or living with HIV: when the accompanying adult received an SMS 2 or 3 days before, 75% came to their appointment, against 51% without a reminder, and 89% with an SMS plus a call. SMS alone was the most cost-effective option.

Vaccination, pregnancy, treatment: what the studies show

Coverage 13% higher means, for example, 79% of children vaccinated instead of 70%. Timing, content and frequency matter: in Kenya, one SMS a week helped patients stay on treatment, one a day did not.

What to text patients: 7 SMS examples for hospitals and clinics

A good hospital or clinic SMS asks for one clear action: come in, call, bring a document. Each example fits in a single SMS.

How to write an effective patient SMS

An effective patient SMS fits in one message, carries the facility’s name, says when and where to come, and how to cancel.

• One SMS: 160 characters in GSM-7, the standard SMS alphabet, or 70 in Unicode (a few symbols such as € and most emojis count twice); beyond that, the message is split into segments, each billed as one SMS (see our guide to bulk SMS in the DRC).
• A recognisable Sender ID: a Sender ID is the name displayed as the sender instead of a phone number, for example “CliniqueLux” (11 characters at most under the GSM standard). Patients recognise their clinic, but cannot reply to it.
• The right day: the day before or on the day for a vaccine, according to the 2019 meta-analysis; for an appointment booked far ahead, 2 or 3 days before, then the day before.
• The right time: during the day, never at night. The DRC has two time zones: 8 am in Kinshasa is 9 am in Lubumbashi.

Privacy: what should never appear in a medical SMS?

No diagnosis, no result, no disease name and no department that reveals one. An SMS shows on the lock screen and can be read on a shared phone: it asks the patient to come in, and medical information is given during the consultation.

The WHO stressed in 2019 that no one should be put at risk for receiving information on a sensitive health topic. Yet none of the 27 trials in a 2020 Cochrane review reported data on unintended consequences, such as breaches of confidentiality.

In the DRC, the 2023 Digital Code classifies health data as sensitive data, which may be processed only in specific cases, such as the patient’s explicit consent or the provision of care (articles 2 and 195). Direct marketing in principle requires prior consent and a free way to opt out (articles 68 and 72), read more strictly when it targets sick people (article 71). Have your practices checked by your lawyer.

Can patients reply? SMS, phone call or WhatsApp

Not to a Sender ID, which cannot receive replies: for two-way confirmation, give a number to call or a WhatsApp number.

In the Kenyan WelTel trial (2010), patients on HIV treatment received a weekly SMS from a nurse and had to reply within 48 hours: 62% reported good adherence to their treatment, against 50% without SMS.

In patient communication, channels work together: SMS works even without internet, and on WhatsApp Business, connected patients can confirm and put their questions to the whole team. To write first, the facility uses a template approved by Meta; it can reply freely for 24 hours after a patient’s message.

Vaccination campaigns and alerts: the DRC example

An SMS campaign announces a health event to a population: vaccination, screening, alert. It works when the message is short, dated, local and written in the recipients’ language.

In 2021, UNICEF and its partners, with Orange, Vodacom and Africell, sent free messages encouraging COVID-19 vaccination registration to around 16 million people in 15 provinces of the DRC. People only had to text INFO to a free number, then choose one of five local languages. In less than four weeks, around 54,000 people had registered.

SMS is not enough on its own: in Kenya, in the M-SIMU trial (2017), reminders alone did not significantly change full immunisation at 12 months (86% against 82%). Target by area and age group, write in French or a national language (Lingala, Swahili, Kikongo, Tshiluba), and test a reminder the day before or on the day.

Setting up patient SMS with Coussema

Coussema sends your patient SMS from a dashboard, without code, or from your software through an API (application programming interface). An SMS to the DRC costs $0.03 on the Growth plan, with no subscription, paid by Mobile Money, and the SMS you buy never expire.

1. Create your account: signing up gives you 10 free SMS.
2. Request your Sender ID: free, usable once approved, on the Growth plan.
3. Import your consenting patients into groups (.xlsx, .csv or .txt file).
4. Test, then send or schedule the campaign.
5. Track the SMS report: each message has its status (Reçu, Envoyé, Échec, Non confirmé…); only Reçu (delivered) confirms delivery.

For high volumes, Enterprise pricing is available on request (pricing).

To automate, your software calls POST https://api.coussema.com/v1/sms/send with an Idempotency-Key header, a unique value per send; the 202 Accepted response means “accepted into the sending queue”, not “delivered”, and status updates arrive by webhook, an automatic call to your server. In clientReference, put an appointment number, never medical data.

curl -X POST https://api.coussema.com/v1/sms/send \
  -H "Authorization: Bearer $COUSSEMA_API_KEY" \
  -H "Content-Type: application/json" \
  -H "Idempotency-Key: appt-48213-day-before" \
  -d '{
    "to": "243810000000",
    "message": "Reminder: you have an appointment tomorrow at 9:30 am. To cancel or reschedule, call 0810000000.",
    "senderName": "CliniqueLux",
    "clientReference": "appt-48213"
  }'

See the API quickstart and webhooks. Coussema SMS currently covers the DRC; other destinations are opening.