Although a new armamentarium has greatly benefitted patients with retinal disease, novel therapeutic approaches require more frequent clinic visits, which may lead to missed treatments and vision loss. This study characterizes patient-reported reasons for missed visits and assesses the efficacy of calling patients for rescheduling missed visits.
This retrospective cohort study included patients who missed an appointment for an intravitreal injection between January 2018 and February 2020 at the Retina Service of Wills Eye Hospital. Two calls were made to each patient by an appointment specialist to reschedule the visit and record a reason for the missed appointment. Reasons were categorized and the efficacy of each round of phone calls was assessed with stratification by sociodemographic information. Multivariate regression analyses were conducted (SPSS).
Patients from 8,794 missed intravitreal injection visits received up to two phone calls. The most common patient-reported reasons for missed visits were: Medical Issues (776, 9%) and Hospitalization (720, 8%). On the first call, 1,000/7,667 (13%) patients were rescheduled and 2,456/5,645 (44%) patients were rescheduled on the second call. In multivariate analyses, oldest age quartile [OR 0.70 (CI 0.6-0.8), p<0.001] and 2nd lowest adjusted-gross income quartile [OR 0.83 (CI 0.7-0.9), p=0.004] were significantly associated with worse rescheduling rates, while sex and race were not significantly associated.
Comorbid medical conditions pose a challenge to patients and physicians managing retinal disease with frequent, in-clinic treatments. Phone calls may be an effective mechanism for rescheduling missed visits, although alternative strategies may be needed to improve rescheduling rates among certain populations.
Recommended CitationWibbelsman, Turner D.; Ammar, MD, Michael; Obeid, MD, MPH, Anthony; and Hsu, MD, Jason, "Efficacy of an Appointment Specialist in Reducing Loss to Follow Up in a Retina Practice" (2021). Phase 1. Paper 6.