ప్రాథమిక సంరక్షణలో నాణ్యత అందరికి ప్రవేశం

నైరూప్య

The Impact of Personalized Telephone Reminders on Diabetes Core Measures and No-Show Rates in a Resident Clinic; A Cross-Sectional Study

Fatima Ali-Ahmed, Alexandra Halalau

Objective: Patient noncompliance with laboratory tests, e.g., American Diabetes Association-recommended diabetes core measures (DCMs), contributes to the epidemic of uncontrolled diabetes, causing long-term complications and increased healthcare costs. Since our resident clinic struggles with low compliance and low follow-up by diabetic patients, we hypothesized that personalized telephone reminders would enhance patients’ compliance with their laboratory DCMs, while also decreasing their “no-show” rates.

Methods: A cross-sectional study was performed at Beaumont Health, Royal Oak, Michigan. 150 diabetic patients overdue for their laboratory DCMs (HbA1c, annual urine microalbumin, creatinine and fasting lipid panel) were identified and divided into two groups of 75 patients. The first group had their overdue laboratory DCMs preordered and received a personalized telephone reminder the week prior to their appointment, with instructions to arrive a half hour early, to have their overdue laboratory DCMs done. The second group’s laboratory DCMs were not preordered, nor did they receive a personalized telephone encounter. Both groups received an automated telephone reminder two days prior to their appointment. Our primary outcome looked at patient compliance with their laboratory DCMs; our secondary outcome looked at decreasing the “no-show” rate.

Results: Patients’ compliance with laboratory DCMs was 77.33% vs. 14.66% (p<0.001) in the telephoned group vs. the non-telephoned group (OR 19.82; 95%CI, 8.59-45.86). The “no-show” rate was also significantly decreased (18.66% vs. 61.33%, p<0.001), in the telephoned group, compared to the non-telephoned group (OR 6.91; 95%CI, 3.28-14.54).

Conclusion: Our relatively simple and cost-effective intervention led to a statistically significant improvement in patients’ compliance with their laboratory DCMs, and also decreased no-show rates. This intervention could potentially facilitate better disease management, thus lowering the risk and health care cost of diabetes complications.