The effectiveness of a letter reminder on the compliance with periodic follow-up examination in chronic HBsAg-positive patients

ABSTRACT

BACKGROUND: For Chronic HBsAg-positive patients are a well-known high risk group of primary liver cancer necessitating periodic follow-up examination. This study was performed to evaluate the effectiveness of a reminding letter on the compliance with scheduled follow-up examination in chronic HBsAg-positive patients. METHODS: A randomized controlled clinical trial was conducted at a Family Practice Clinic in Samsung Medical Center located in Seoul from February 1998 to January 1999. A total of 176 HBsAg-positive patients who had no other clinical illnesses and were scheduled to take follow-up examination were randomly assigned to a control (88 subjects) and a letter reminder group (88 subjects). The outcome measure and attendance at the scheduled follow-up examination were determined through the medical chart review and telephone. Demographic and clinical characteristics were checked through the medical chart review. RESULTS: The attendance rate was 62.2% among the 82 patients who were actually receiving the letter reminders. Compared to the attendance rate of 37.5% among the control group, it was significantly higher. Even after controlling the demographic and clinical characteristics through the multiple logistic regression analysis, the letter reminder was significantly related to the increased compliance for a scheduled follow-up examination. Frequency of previous visit was also positively related to increased compliance. CONCLUSION: These results suggest that the letter reminder can significantly improve compliance with a scheduled follow-up examination in HBsAg-positive patients.