April 2014
Volume 55, Issue 13
ARVO Annual Meeting Abstract  |   April 2014
A Comparison of Three System-Based Interventions to Improve Follow-Up Adherence in a Primary Eye Care Setting
Author Affiliations & Notes
  • Brianna Kenney
    Wills Eye Hospital, Philadelphia, PA
  • Lisa A Hark
    Wills Eye Hospital, Philadelphia, PA
  • Ann P Murchison
    Wills Eye Hospital, Philadelphia, PA
  • Robert Bailey
    Wills Eye Hospital, Philadelphia, PA
  • Julia A Haller
    Wills Eye Hospital, Philadelphia, PA
  • Joseph A Bilson
    Wills Eye Hospital, Philadelphia, PA
  • Footnotes
    Commercial Relationships Brianna Kenney, None; Lisa Hark, None; Ann Murchison, None; Robert Bailey, None; Julia Haller, Advanced Cell (C), Allergan (C), Merck & Co (C), Second Sight Medical Products (C), ThromboGenics (C); Joseph Bilson, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 6096. doi:
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      Brianna Kenney, Lisa A Hark, Ann P Murchison, Robert Bailey, Julia A Haller, Joseph A Bilson; A Comparison of Three System-Based Interventions to Improve Follow-Up Adherence in a Primary Eye Care Setting. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6096.

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

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Patient adherence to recommended follow-up appointments in an urban ophthalmology clinic is often suboptimal and can impact patient outcomes. The purpose of this study was to compare three system-based interventions to improve follow-up adherence rates in patients who were recommended by an ophthalmologist to follow-up in 6 months, 1 year and 2 years.


A total of 1096 patients with a 6-month, 1-year, or 2-year recommended follow-up appointment date during September 1, 2013 to November 30, 2013 were randomized into three groups: usual care, automated telephone call, and personalized telephone call. The usual care group was sent personalized reminder letters 1-month prior to their recommended appointment date. The automated telephone call group was reminded to schedule an appointment using a PAM2000 phone system 1-month before their recommended dates. The personalized telephone call group was contacted by staff 1-month before their recommended follow-up dates and given the opportunity to schedule an appointment at the time of the call. Adherence was determined using electronic health records by evaluating whether the patients scheduled and kept their appointments.


The majority of patients were African American (62%) and female (60%). The mean age was 57 years. Preliminary data indicates that 43% of patients across all groups scheduled an appointment. When examining scheduling rates by group, 53% of the personal telephone call group, 40% of the automated telephone group and 37% of the usual care group scheduled an appointment. Patients in the personal call group were significantly more likely to schedule an appointment compared to the two other groups (p=0.016). Automated telephone calls were not successful in significantly increasing patient adherence to recommended follow-up dates (p=0.427). Complete patient scheduling and follow-up adherence results can be found in Table 1.


General ophthalmology clinics could consider utilizing personal telephone calls to improve recommended follow-up scheduling. Patients who were personally called were significantly more likely to make an appointment. This improvement in follow-up adherence could improve patients’ future outcomes as well as clinic revenue.

Keywords: 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • 462 clinical (human) or epidemiologic studies: outcomes/complications • 465 clinical (human) or epidemiologic studies: systems/equipment/techniques  

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