June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Educational and Personal Reminders to Improve Follow-Up to Vision Care in Patients with Diabetes: A Prospective, Randomized Trial
Author Affiliations & Notes
  • Camila Zangalli
    Research, Wills Eye Institute, Philadelphia, PA
    Thomas Jefferson University, Philadelphia, PA
  • Ann Murchison
    Research, Wills Eye Institute, Philadelphia, PA
    Thomas Jefferson University, Philadelphia, PA
  • Nicole Hale
    Research, Wills Eye Institute, Philadelphia, PA
  • Yang Dai
    Research, Wills Eye Institute, Philadelphia, PA
    Thomas Jefferson University, Philadelphia, PA
  • Lisa Hark
    Research, Wills Eye Institute, Philadelphia, PA
    Thomas Jefferson University, Philadelphia, PA
  • Laura Pizzi
    Research, Wills Eye Institute, Philadelphia, PA
    Thomas Jefferson University, Philadelphia, PA
  • Benjamin Leiby
    Research, Wills Eye Institute, Philadelphia, PA
    Thomas Jefferson University, Philadelphia, PA
  • Philip Storey
    Research, Wills Eye Institute, Philadelphia, PA
  • Julia Haller
    Research, Wills Eye Institute, Philadelphia, PA
    Thomas Jefferson University, Philadelphia, PA
  • Footnotes
    Commercial Relationships Camila Zangalli, None; Ann Murchison, None; Nicole Hale, None; Yang Dai, None; Lisa Hark, None; Laura Pizzi, None; Benjamin Leiby, None; Philip Storey, None; Julia Haller, Allergan (F), Advanced Cell Technology (C), Regeneron (C), Merck (C), Second Sight (C), KalVista (C), ThromboGenics (C), Optimedica (I)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 215. doi:
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    • Get Citation

      Camila Zangalli, Ann Murchison, Nicole Hale, Yang Dai, Lisa Hark, Laura Pizzi, Benjamin Leiby, Philip Storey, Julia Haller; Educational and Personal Reminders to Improve Follow-Up to Vision Care in Patients with Diabetes: A Prospective, Randomized Trial. Invest. Ophthalmol. Vis. Sci. 2013;54(15):215.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To evaluate the effectiveness of a personalized educational and telephone-based intervention on dilated fundus examinations (DFE) follow-up in patients with diabetes.

 
Methods
 

Prospective study of adults with diabetes who were recommended for a follow-up DFE. Over 7 months, 522 patients were randomly assigned to usual care or the intervention group. Usual care group (n=260) received a standard form letter reminding them to make an appointment and, once an appointment was made, they received an automated reminder phone call one day prior to their scheduled follow-up visit. Patients in the intervention group (n=262) received an educational brochure about diabetic eye disease and a personalized letter encouraging them to schedule an eye exam. Two weeks after the letter and brochure were mailed, a research assistant called to provide personal assistance to schedule a follow-up eye exam. Barriers to care utilization were also captured. Once an appointment was made, patients in the intervention group received a reminder letter 3 weeks prior to their appointment and an automated phone call one day prior to the scheduled follow-up visit.

 
Results
 

Patients in the intervention and control groups had similar demographics with regards to gender, race, and age. Overall, the majority of patients were female (66%) and African-American (70%). The mean age was 61 years (range 19-95 years). Patients in the intervention group were more likely to schedule an appointment (68% vs. 44%; relative risk 1.55; 95% confidence interval 1.29-1.79; p <0.0001) compared to the usual care group. Patients in the intervention group were equally likely to keep their appointment once scheduled compared to the usual care group (73.3% vs. 71.3%; p =0.71). Of those who did not make an appointment, common barriers reported included other medical conditions, lack of transportation, busy schedule, being a caretaker for a family member, and lack of health insurance.

 
Conclusions
 

Our study shows that the combination of a personalized educational and telephone-based intervention can significantly improve follow-up among patients with diabetes. A follow-up study has been initiated to determine the impact of each component separately as well the operational costs of each of these components.

 
Keywords: 499 diabetic retinopathy • 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials  
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