REPORTING FROM ENDO 2018
CHICAGO (FRONTLINE MEDICAL NEWS) – Sending robocall reminders increased diabetic retinopathy screenings significantly among low-income, minority patients, according to a presentation at the annual meeting of the Endocrine Society.
Patients with diabetes require routine diabetic retinopathy (DR) screenings as it is usually asymptomatic until vision loss, explained presenter Eli K. Ipp, MD , professor of medicine at the University of California, Los Angeles. Sending robocalls is an easy, relatively cheap solution to encourage patients to seek screening, especially for certain populations that may be less inclined to spend the time and money to do so.
“Diabetic retinopathy screening, when routine and periodic, is the only method that can pick up DR early enough to treat and prevent blindness,” said Dr. Ipp. “Robocall reminders improved the overall show rate for diabetes retinal screening in a low-income minority population.”
Investigators used EHRs to randomly selected 350 patients with diabetes to receive either a prerecorded message 1-7 days ahead of an existing appointment or a phone call from a staff member reminding patients of an upcoming appointment, during the course of 7 weeks.
Patients included were aged 54-58 years, and 70% were Hispanic and 30% were African American, with more than half this population having less than a high school education and three-quarters having an income less than $25,000.
Overall show rate for screenings was almost 14% higher in the robocall group (59.9%) than in the control group (46.3%).
Among African Americans, the program worked especially well, closing the gap with Hispanic patients, who reported attending their appointments nearly twice as often as did African American patients the previous year.
“Automated robocall reminders are an effective, potentially low-cost approach to appointment reminders in safety-net clinics,” Dr. Ipp explained to attendees. “Robocall almost eliminated the African American disparity seen with usual care in this population.”
Implementation of the robocalls is also relatively simple since the programs used to find the patients and create the calls are readily available, although investigators chose to gather the data for this study by hand, according to Dr. Ipp.
Screening rates in the United States are disconcertingly low, Dr. Ipp pointed out. While screening rates were around 70% in Medicare patients, rates among Medicaid and commercially insured patients hovered between 47.5%-54.9%, according to data collected by the National Committee for Quality Assurance.
Rates are especially low among minorities, as seen by a difference in screenings between minorities and non-Hispanic whites that ranged from 7% to15% during 2002-2009, according to a study cited by Dr. Ipp.
Dr. Ipp reported no relevant financial disclosures.
SOURCE: Mehranbod C et al. ENDO 2018, Abstract OR27-4 .