Абстрактный

Effectiveness of a telephone outreach intervention on visit adherence in patients with uncontrolled cardiovascular risks

Elisha Brownfield*, Kavin Panneerselvam, Kimberly Davis, Jingwen, Zhang, William Barry, Justin Marsden, William P Moran, Patrick Mauldin

 Purpose: To determine the effectiveness of a telephone outreach intervention on visit adherence in patients with uncontrolled cardiovascular risk factors. Methods: A telephone outreach intervention designed to effect clinic visit adherence was conducted on patients with uncontrolled cardiovascular risks. The patient sample was drawn from adults ≥ 18 years of age who had received primary care from the University Internal Medicine (UIM) primary care clinic at the Medical University of South Carolina (MUSC) between 01/01/2014 and 02/30/2017. Patients were selected for a telephone outreach if they had three cardiovascular risk diagnoses, a current UIM primary care provider, at least one of their most recent lab values over goal: HbA1C ≥ 8%, systolic BP ≥ 140 or LDL ≥ 130, and no documented UIM visit within the previous 3 months. Barriers to visit completion were identified, and visit completion status was determined 3 months after the phone call intervention. Results: Of the 556 patients receiving the intervention, 393 patients completed an ambulatory clinic visit within 3 months. The majority (84.7%) of the patients with the completed visit had Medicare or Medicaid funding and the mean age of visit completers was 65 years. 72.8% of African American patients and 58.0% Caucasian completed their visits. The main barriers to visit completion included transportation, funding issues and work conflicts with clinic appointments. Conclusion: Our findings indicate that a phone call outreach intervention effectively influenced primary care visit completion rates in a group of patients with uncontrolled cardiovascular risk factors. Transportation, funding issues and work schedule issues were the main barriers to visit completion. African American patients had a higher percentage of visit adherence than Caucasian patients.