Purpose
This randomized, prospective study evaluated the effectiveness of an intervention that utilized personalized reminder letters and telephone calls to increase follow-up adherence in patients with glaucoma in an urban, tertiary eye care clinic.
Methods
Patients previously diagnosed with glaucoma and scheduled for a 1-month, 3-month, or 6-month follow-up appointment between September 1, 2013 and November 30, 2013 were randomized into the usual care group or the intervention group. Patients in the usual care group did not receive a reminder call or letter prior to their appointment and did not receive phone calls to reschedule if they did not attend their appointment. Patients in the intervention group received a personalized reminder letter 2 weeks before their scheduled appointment and a reminder phone call 1-2 days before their appointment. If the patient in the intervention group did not attend their appointment, they were called up to 2 times to reschedule. If these intervention patients failed to reschedule their appointment, a personalized letter was sent to their home. Follow-up adherence was recorded using electronic health records. Demographic data were also documented.
Results
The final sample size included 250 patients. Male and females patients were equally represented. The majority of patients were African-American (56%), with an average age of 69 years. Preliminary results with 177 patients demonstrate that 83% of patients in the intervention group were adherent to their recommended follow-up appointment, compared to 71% in the usual care group (p = 0.078). However, this difference is only approaching statistical significance. Patients over the age of 60 were significantly more likely to adhere to their follow-up appointment regardless of intervention group (p = 0.01).
Conclusions
Tailored phone calls and letters may increase follow-up adherence among patients with glaucoma in an urban tertiary eye care clinic. While the effectiveness of the intervention did not increase with patient age, patients over age 60 were more likely to adhere to their follow-up appointment. Therefore, future interventions to increase adherence in glaucoma patients should target younger patients.
Keywords: 465 clinical (human) or epidemiologic studies: systems/equipment/techniques •
466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials