An Education- and Telephone-Based Intervention to Improve Follow-up to Vision Care in Patients With Diabetes: A Prospective, Single-Blinded, Randomized Trial

Am J Med Qual. Mar-Apr 2016;31(2):156-61. doi: 10.1177/1062860614552670. Epub 2014 Sep 30.


The aim was to evaluate the effectiveness of a multipronged intervention on diabetic dilated fundus examination (DFE) adherence. In a prospective trial, 521 patients with diabetes who were due for follow-up DFEs were randomized to usual care or the intervention group. Usual care received a form letter reminder to schedule and an automated reminder phone call prior to their appointment. Intervention participants received an educational brochure about diabetic eye disease and a personalized letter reminder to schedule. A research assistant called intervention participants to help schedule the appointment, and they received a reminder letter and an automated phone call prior to the scheduled visit. Patients in the intervention group were significantly more likely to schedule (63% vs 40%; P < .0001) and complete their appointment (48% vs 30%; P < .0001) compared with usual care. A multipronged intervention, including an educational mailing and telephone assistance with scheduling an appointment, significantly improved diabetic DFE adherence.

Keywords: diabetes care; diabetic retinopathy; eye care adherence; intervention.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Diabetes Mellitus / therapy*
  • Diabetic Retinopathy / diagnosis*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance*
  • Prospective Studies
  • Reminder Systems*
  • Single-Blind Method
  • Socioeconomic Factors
  • Telephone
  • Young Adult