Low-Tech, High Impact: SMS’s Remarkable Open Rates Boost ePRO Compliance

Electronic Patient-Reported Outcomes (ePRO) systems have revolutionized how data is collected in clinical trials. But with the emergence of numerous notification methods like email and app push alerts, an often overlooked yet remarkably potent tool persists: SMS notifications. Here, we’ll explore why SMS notifications stand out and can significantly enhance ePRO efficiency in clinical trials, as we have seen ourselves in Trial Online ePRO

Instant Accessibility 

SMS notifications offer unparalleled immediacy. Unlike emails, which may sit unread in an inbox, or app notifications, which require smartphone and app usage, SMS reaches participants directly and promptly. This immediacy is critical in clinical trials where timely data submission is vital. 

Higher Open Rates 

Studies indicate that SMS messages have an astounding 98% open rate, compared to emails which linger around 20-30%. This high open rate ensures that participants are more likely to read and respond to SMS messages, leading to more consistent and timely data collection in ePRO. 


Simplicity is key. Not all clinical trial participants are tech-savvy or comfortable with modern apps. SMS, being a fundamental feature of mobile phones, is user-friendly and accessible to a broader demographic, making it easier for participants of all ages and tech proficiencies to contribute to the trial. 

Reduced App Fatigue 

Being the current app overload real, SMS stands out. Participants may feel overwhelmed by numerous app notifications, leading to ‘notification fatigue’. SMS, on the other hand, bypasses this clutter, directly reaching the participant without the need for any specific app. 

Enhanced Compliance and Engagement 

The immediacy and ease of SMS notifications can boost patient compliance and engagement. With reminders and alerts sent directly to their phones, participants are more likely to adhere to trial protocols and timely data submission, enhancing the quality and reliability of the collected data. 

Case Studies and Statistics 

Several case studies have demonstrated the effectiveness of SMS in ePRO. For instance, in a recent trial, participants receiving SMS reminders showed a 40% higher compliance rate compared to those who received email notifications. Moreover, the average response time for SMS was significantly lower, indicating quicker participant engagement.

In conclusion, SMS notifications in ePROare a powerful tool in clinical trials. They provide immediacy, high open rates, ease of use, and reduce app fatigue, which overall enhances participant compliance and engagement. As the clinical research community continues to evolve, leveraging the full potential of SMS in ePRO can lead to more efficient, reliable, and successful clinical trials. 

Read more on how Trial Online ePRO increases patient engagement and compliance👆.


SMS Open Rates: According to Mobile Marketing Watch, SMS text messages have an exceptional open rate of 98%, significantly higher than other marketing tools. This indicates the effectiveness of SMS notifications in reaching and engaging participants in clinical trials. 

Email Open Rates: Mailchimp reports that the average email open rate across various industries is approximately 21.33%. This rate, although industry-standard for email communications, is substantially lower than that of SMS, impacting the effectiveness of email notifications in ePRO data collection. 

App Push Notification Open Rates: TrueList notes that the average open rate for push notifications is about 7.8%. However, this rate varies widely, ranging from as low as 0.2% to as high as 80%, depending on factors such as the app, segment, content, and campaign type. 

About the author:

Picture of Christer Nilsson

Christer Nilsson

Christer Nilsson is a serial entrepreneur and the Chief Executive Officer at Replior, offering the Trial Online suite. Christer has a track record of leading several successful businesses in the IT, Finance and Life Science sector in the past 30 years.

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