• Appl Health Econ Health Policy · Apr 2016

    Randomized Controlled Trial

    Effectiveness and Cost of a Personalized Reminder Intervention to Improve Adherence to Glaucoma Care.

    • Laura T Pizzi, Judie Tran, Anousheh Shafa, Michael Waisbourd, Lisa Hark, Ann P Murchison, Yang Dai, Eileen L Mayro, and Julia A Haller.
    • Thomas Jefferson University, 901 Walnut Street, Room 911, Philadelphia, PA, 19107, USA. laura.pizzi@jefferson.edu.
    • Appl Health Econ Health Policy. 2016 Apr 1; 14 (2): 229-40.

    BackgroundGlaucoma is the leadi ng cause of irreversible blindness in the USA. Glaucomatous vision loss is preventable with proper eye care, including appointment adherence. Therefore, interventions that improve appointment adherence can reduce the number of patients with more severe glaucoma.ObjectivesThe primary study aim was to determine the efficacy and cost-effectiveness of a multifaceted personal reminder intervention, which included a customized letter and personal telephone outreach, in improving appointment adherence of patients with glaucoma. A secondary study aim was to identify patient characteristics that were associated with non-adherence.MethodsThis prospective, randomized, controlled study included a cost-effectiveness analysis completed using a decision analytic model. The subjects included 256 patients with glaucoma. Study measures included appointment adherence and incremental cost effectiveness ratios.ResultsPatients in the intervention group were more likely to adhere to appointments (82.31 vs. 69.05 %; RR 1.23; 95 % CI 1.04-1.37, p < 0.012) than patients in the usual care group. Patients in the intervention group were 23 % more likely to adhere to appointments (RR 1.23; 95 % CI 1.08-1.41, p < 0.0021) than patients in the usual care group, when adjusting for age, secondary insurance, primary open angle glaucoma diagnosis, number of previous visits at Wills Eye Hospital, and follow-up recommendation using Poisson regression. Per-patient cost of the program was US$11.32, and cost per follow-up attended within the adherence window was US$73.56.ConclusionsA low cost reminder intervention consisting of a personalized letter and telephone outreach significantly improved appointment adherence of patients with glaucoma.

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