Impact of Personalized Mail and Telephone Interventions to Improve Follow-up to Vision Care in Patients with Diabetes: Results from Two Randomized Prospective Trials

Document Type

Presentation

Publication Date

6-25-2013

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Committee:

Lisa Hark, PhD, RD (Capstone Chair), University of Pennsylvania School of Medicine

Benjamin Leiby, PhD, Thomas Jefferson University

Laura Pizzi, PharmD, MPH, Thomas Jefferson University

Abstract

The purpose of this project was to evaluate the effectiveness of personalized mail and telephone interventions to improve follow-up to vision care in patients with diabetes. The project was divided in two parts. In the first study, 521 patients with diabetes who were due for a follow-up dilated fundus examination (DFE) were randomly assigned to receive 1) a single-mailed reminder form letter (usual care), or 2) a reminder letter plus an educational brochure, followed by a telephone call to schedule a DFE. In the second study, patients with diabetes were randomly assigned to receive 1) a single-mailed reminder letter (usual care), or 2) a personalized reminder letter plus an educational brochure or, 3) usual reminder letter plus a telephone call to schedule the DFE. Barriers to care utilization were also captured. The primary outcome was completion of a DFE within 3 months of suggested return date (timely appointment). Overall, all intervention groups were similar regarding demographic characteristics with a majority being female and African American. A combination of personalized mail and telephone communications and telephone communications alone were more effective in improving DFE adherence than a strategy based solely on standard mailed reminders. However, including an educational brochure did not enhance the effectiveness of the telephone-based intervention. Most commonly reported barriers to scheduling a DFE included busy schedule and issues with health insurance. In summary, a low cost telephone-based intervention significantly improves DFE adherence in an urban primary eye care setting.

Presentation: 17 minutes

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