Using a text message service to contact GP surgery patients proved to be key to successful registrations in the East Staffordshire and West Midlands regions. Working closely with GP practice managers, the National Institute for Health and Care Research (NIHR) Clinical Research Network West Midlands (CRN WM)  found a way of reaching patients directly that was simple for practices to implement. 

Jacqueline Smart, Research Facilitator and Join Dementia Research Lead, NIHR Clinical Research Network, West Midlands

The Join Dementia Research Primary Care steering group within the CRN WM was keen to engage GP patients – historically one of the hardest groups to reach when finding volunteers for the service. When the Covid pandemic hit in early 2020, Research Facilitator Gerri Mulcahy thought that text messaging patients could be the key to reaching them directly.

She explains: “We have a group of GP practices in East Staffordshire that are very research-active, and many use a text messaging system called MJOG to message their patients. The system allows a text with a link to be sent instantly to however many patients they choose.”

Five GP practices were chosen, with a total catchment of 25,000. Research Facilitator Mark Evans set up an MJOG-compatible search that practices could use, which looked for all patients over 18 and removed any who had requested that practice contact be kept to a minimum.  This allowed the practices to run the search themselves, export the file to MJOG, and send out a prepared message, which read: “Join Dementia Research is a service supported by (GP practice name) and the NHS to help advance dementia care and treatment. You can register with or without a diagnosis. If you’re over 18, for more information please visit the Join Dementia Research website” – with a link to the website.

Reaching patients directly

As a result, 51 patients signed up to Join Dementia Research – an encouraging result says Gerri Mulcahy. “A big event, such as a dementia walk, would typically result in about 10-15 registrations to the service. So reaching out directly to patients was much more efficient, solely from that point of view.”

In 2021, the team decided to use the same method to coincide with Dementia Action Week. This time, they chose three different GP surgeries in the West Midlands, two with particularly high populations: Westgate Practice (28,500), Cambrian Surgery (13,000), and TelDoc (45,000 patients).

The response was far better than expected. Initially, it appeared that 73 people in the relevant postcodes had signed up to the Join Dementia Research service as a result of the text message – but after checking other areas, the team found that there had been many more registrations. In total, 163 patients ultimately signed up for the service.

Utilising a GP text messaging service to raise awareness

Jacqueline Smart
Clinical Research Facilitator NIHR Clinical Research Network West Midlands

What did you want to do and why?
The steering group with a primary care team were really interested in seeing whether we could reach out to GPs to help assist with promoting Join Dementia Research. And historically, we found it quite difficult to actually register people from a GP practice.

How did the COVID pandemic impact the project?
During the COVID-19 pandemic, we recognised as a team that we needed to look at alternative ways in which we could actually reach out to the public to let them know about Join Dementia Research. Within the East Staffordshire region we have a group of GP surgeries who are very, very research active and one of the things they are very good at using as well is the text messaging service just to promote ideas to their patients or to inform them of stuff so we thought, is there opportunity there for us to reach out to these GP practices to see whether we could promote Join Dementia Research via the text messaging service.

What happened next?
Initially we approached five practices to see whether they would be involved and they did say they would be quite happy to do so. They had a catchment area between the five of them of about 25,000 people and the proviso was that as long as anybody was over the age of 18 and they were actually happy to receive a text message from the GP service, those were the ones that were chosen and the message was sent out to them.

How did this approach compare to other recruitment initiatives?
We were really quite pleased with the initial results from this because we had 51 people actually sign up to Join Dementia Research and we found that this was actually really quite an easy way to do it it didn’t take that much time and for comparison, we did attend the dementia walks that go on a couple of times a year with the Alzheimer’s Society and at one of the walks that we actually attended we had 15 people volunteer, so we thought we did really well.

In 2021 the team used the text message initiative to coincide with Dementia Action Week. It resulted in 163 patients signing up to the service.

Role of the GP practices
I think more than anything else, we would really, really like to thank the GP practices for getting involved because we know they have so much to deal with especially over the COVID-19 period, and it’s just a big thank you. Thank you for supporting us.

Lessons learnt
The lessons that we actually learnt from this was we think timing is essential. So let’s look at Dementia Action Week or maybe Alzheimer’s Month because it’s in the public psyche and it’s being promoted widely. Getting your practice managers on board, I think, is key to this as I think everybody would agree. Maybe even looking at the initiative itself, can it be tweaked? Which is something that we did. We just looked at it and thought, well, rather than going for lots of practices lets maybe keep it a little bit smaller to manage. Then I would also say that text messaging is really quite inexpensive, so it didn’t really cost much at all to do.

Developed in partnership:
NIHR | National Institute for Health and Care Research
Alzheimer Scotland | Action on Dementia
Alzheimer’s Research UK
Alzheimer’s Society | United Against Dementia


Record results

Jacqueline Smart, CRN WM Research Facilitator and Join Dementia Research Lead, says: “We realised that because the catchments for these particular surgeries were quite widespread, the postcodes that were subsequently messaged had been more extensive than we’d expected. To get 163 registrations from a single text message in such a short period of time is superb – I just couldn’t believe it when the figures started coming through! That’s definitely a record for us.”

Of those registrations onto the Join Dementia Research service, over a quarter were registered as with a dementia condition diagnosis or an unspecified related diagnosis, and 13% registered as a dementia carer.

The initiative may also have benefited from national and local publicity about Dementia Action Week.

Jacqueline Smart says: “The surgeries’ cooperation was fundamental to the success of this. Although we provided the search for them, and they were paid, they had a lot of coordination to do. For example, they had to make sure all the practice staff knew when the message was going out, in case patients rang to check whether it was a genuine message. They also provided staff with  information about the service so that they could answer any questions.”

Changing attitudes to research

Gerri Mulcahy says: “Using text messages is a win for these practices. It’s only right that they inform patients of a service that is out there that supports them, and allows them to help other people. And it’s an easy method of reaching them if they have a batch messaging system installed.”

Jacqueline also thinks the pandemic may have changed attitudes to research. “We had piloted the initiative previously in 2019 with a good result and were keen to establish if the public would be interested in other forms of research rather than COVID related.  Since everyone has been affected by the pandemic and had been following the news about the UK’s vaccine successes, I think people now want to be a part of health research because they’ve seen the results it can have.”

There are now plans to repeat the initiative with other GP practices in the area.

Lessons learned:

  • Timing can be everything! Sometimes an awareness week can provide a focus for an initiative
  • Tweaking an existing initiative can make it more successful
  • GP practice managers are essential to any patient-focused primary care initiatives
  • Text messaging is an inexpensive way of contacting large numbers of people directly