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P. Ramulu, H. A. Quigley, D. S. Friedman; A Randomized Controlled Trial to Increased Compliance With Glaucoma Follow-Up Visits. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5577.
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To test whether a multi-faceted intervention could increase compliance with follow-up visits in patients with a glaucoma-related diagnosis.
Patients being seen for glaucoma or glaucoma suspicion in the residents' clinic at the Wilmer Eye Institute were enrolled and randomized (at a predicted 1:1 ratio) to receive usual care or usual care along with a multi-faceted intervention designed to improve visit compliance. Patients enrolled into the usual care group had their normal physician visit, received a follow-up appointment scheduled at the end of the visit, and were mailed a copy of their next appointment day right shortly after the appointment was made. Patients in the intervention group also watched a video about glaucoma on the day of their enrollment visit, and were reminded of their follow-up visit by both mail and phone. The primary study endpoint was compliance with the next scheduled glaucoma visit.
Ten patients were randomized into the usual care group, and 27 patients were randomized into the intervention group. Both groups were similar in average age, male/female ratio, percentage of patients on treatment, and percentage of glaucoma suspects, though the intervention group did have a longer period until follow-up (4.6 months vs. 2.8 months). Amongst all patients, men were more likely than women to make their follow-up visit (92% vs. 71%), and patients with an interval of 2 months or less until their follow-up visit were more likely to keep their appointment than patients with a visit interval of greater than 2 months (93% vs. 68%). Seven of 10 patients (70%) receiving usual care were compliant with their follow-up visit, while 23 of 27 patients (85%) receiving the intervention were compliant with their follow-up visit.
A multi-faceted intervention including a motivational/education video and visit reminders may improve compliance with glaucoma follow-up visits. These data justify a large-scale trial to test whether this intervention can produce and sustain better compliance rates for glaucoma visits.
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