Robocalls increase retinal screening rates in low-income minorities with diabetes

CHICAGO — Prerecorded telephone reminders may increase screening rates for diabetic eye disease among low-income minority patients, providing pronounced benefit to African-American patients, according to study data presented here.

Diabetic retinopathy is the most common inducer of blindness in working-age U.S. residents.

“Retinal screening can detect signs of diabetic eye disease, such as diabetic retinopathy, before vision loss occurs and progresses to blindness,” Eli Ipp, MD, professor and head of the section of diabetes and metabolism, Los Angeles Biomedical Research Institute and Harbor-UCLA Medical Center in Torrance, California, said in a press release. “Yet, screening rates for diabetic retinopathy are low in low-income minority patients.”

Ipp and colleagues conducted a study to test the effect of telephone reminders in augmenting retinal screening rates. Researchers enrolled 288 patients with diabetes from a safety-net clinic (200 Latino patients and 88 African-American patients); all were uninsured or receiving Medicaid. The clinic is part of the Los Angeles County Department of Health Services. One hundred seventy-six patients received a call from a robocall system to remind them of their upcoming screening appointments. The reminder was in English and Spanish. The remaining 112 patients received a call from the usual care reminder system. According to Ipp, usual care consists of a phone call from a clinic staff member. After the phone calls, researchers monitored the “show rate,” or the percentage of patients who went to their retinal screening appointments at the clinic.

According to the results, patients who received robocalls instead of usual care reminders were 29.4% more likely to show up for their screening appointment (59.9% vs. 46.3%; P = .036). In addition, usual care reminders were correlated to a markedly lower show rate among African-American patients vs. Latino patients (23.6% vs. 55.8%; P =.025). Furthermore, robocalls more than doubled the gap in show rate between African-American patients who received the robocall (51.6%) compared with those who received the usual care reminder (23.6%; P = .023).

Although researchers said they were unsure of why robocalls improved the retinal screening rate in this way, the results show promise.

“Robocalls, a relatively low-cost approach to reminder calls, may not only improve diabetic retinopathy screening rates in low-income minority patients with diabetes, but also appears to correct the disparity in retinal screening observed among African-Americans in this community,” Ipp said. – by Melissa Webb

Reference:

Ipp E, et al. OR27-4. Presented at: The Endocrine Society Annual Meeting; March 17-20, 2018; Chicago.

Disclosure: The study received funding from the California Community Foundation and the Genentech Foundation.