Callinan Catherine E, Kenney Brianna, Hark Lisa A, Murchison Ann P, Dai Yang, Leiby Benjamin E, Mayro Eileen L, Bilson Joseph, Haller Julia A
1 Wills Eye Hospital, Philadelphia, PA.
2 Thomas Jefferson University, Philadelphia, PA.
Am J Med Qual. 2017 Jan/Feb;32(1):73-79. doi: 10.1177/1062860615616860. Epub 2016 Jul 10.
Lack of patient adherence with eye appointments can decrease ocular outcomes. This prospective, randomized, single-blinded controlled study assessed the effectiveness of multiple interventions in improving follow-up adherence to recommended eye appointments. Patients due for follow-up appointments were randomly assigned to usual care, automated intervention, or personal intervention. Automated-intervention patients and personal-intervention patients received a call one month prior to the recommended follow-up date, and a mailed appointment reminder letter. The call was automated for automated-intervention patients and personalized for personal-intervention patients. The primary outcome was adherence to the follow-up appointment. The secondary outcome was rate of appointment scheduling. Patients in the personal-intervention group had greater adherence to follow-up recommendations (38%) than patients in the usual care group (28%) and the automated-intervention group (30%). Personal intervention significantly increased appointment scheduling (51%) over usual care (32%) and automated intervention (36%). These results support systems-level changes to improve patient follow-up adherence in urban primary eye care settings.
患者不遵守眼科预约会降低眼部治疗效果。这项前瞻性、随机、单盲对照研究评估了多种干预措施在提高对推荐眼科预约的随访依从性方面的有效性。应进行随访预约的患者被随机分配到常规护理组、自动干预组或个人干预组。自动干预组患者和个人干预组患者在推荐随访日期前一个月会接到电话,并收到一封邮寄的预约提醒信。自动干预组患者接到的是自动语音电话,个人干预组患者接到的是个性化电话。主要结局是对随访预约的依从性。次要结局是预约安排率。个人干预组患者对随访建议的依从性(38%)高于常规护理组患者(28%)和自动干预组患者(30%)。与常规护理(32%)和自动干预(36%)相比,个人干预显著提高了预约安排率(51%)。这些结果支持在城市初级眼科护理环境中进行系统层面的改变,以提高患者随访依从性。