New York City A1C Registry Patient Outreach: The Patient Perspective
6/9/2012 11:30:00 AM
6/9/2012 1:30:00 PM
, ANITA RICHICHI, BAHMAN TABAEI, ROSA ROSEN, LYNN SILVER, SHADI CHAMANY,
Since 2006, New York City (NYC) laboratories have been mandated to report A1C test results to the NYC Department of Health and Mental Hygiene (DOHMH). A primary activity of this A1C Registry is dissemination of provider and patient tools to improve diabetes control. One tool is a letter mailed by DOHMH (on health care facility letterhead) to adults with A1C test results >9%, informing patients of test results, providing educational material, and encouraging provider visits. Because this type of health department outreach is novel, DOHMH conducted a survey to assess patient response.
A total of 1,266 persons were sent a letter during January 1-March 31, 2009, of whom 292 (23%) were randomly selected for a telephone survey. Respondents were questioned regarding medical history, reaction to the letter, and self-reported health care-seeking and self-management behaviors.
Among 188 persons reached, 86 completed the survey. Fifty-two percent of respondents had diabetes for <10 years; 62% were taking insulin. Upon opening the letter, 53% of respondents reported feeling concerned, 28% interested, 8% scared, 6% did not know/remember, and 5% confused. After reading the letter, the majority of respondents reported feeling motivated (63%) or the same (33%). Overall, 91% of respondents said the letter was easy to understand. Among 77 respondents who reported a scheduled or completed appointment with their doctor since receiving the letter, 22% said the letter had prompted them to make the appointment. Regarding behavior changes among respondents after receipt of the letter, 59% reported changing diet, 36% how they took their medications, and 23% frequency of exercise; 83% reported ≥ 1 of these changes.
Overall, A1C Registry patient letters were well-received with limited negative reaction. The letters appear to have prompted modification of self-management behaviors and promoted follow-up with providers. These findings should be confirmed using outcome data on return to care and A1C levels among letter recipients.
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