Improving diabetes care among patients overdue for recommended testing: a randomized controlled trial of automated telephone outreach.
OBJECTIVE
The study's objective was to assess the effects of automated telephone outreach with speech recognition (ATO-SR) on diabetes-related testing.


METHODS
We identified 1,200 health plan members who were overdue for diabetes-related testing and randomly allocated 600 to ATO-SR and 600 to usual care (no intervention). The intervention included three interactive calls encouraging recommended testing. The primary outcome was retinopathy testing, since this was the health plan's principal goal. Tests for glycemia, hyperlipidemia, and nephropathy were secondary outcomes.


RESULTS
In total, 232 participants (39%) verbally responded to the calls. There was no difference between the intervention and the usual care groups in the primary outcome (adjusted hazard ratio 0.93 [95% CI 0.71-1.22]) and no effect of the intervention on any of the secondary outcomes.


CONCLUSIONS
Fewer than 40% of the patients randomized to ATO-SR interacted verbally with the system. The intervention had no effect on the study's outcomes.
Simon
Steven R
SR
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA. steven_simon@hphc.org
Trinacty
Connie Mah
CM
Soumerai
Stephen B
SB
Piette
John D
JD
Meigs
James B
JB
Shi
Ping
P
Ensroth
Arthur
A
Ross-Degnan
Dennis
D
D003159:Community-Institutional Relations; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000628:therapy*; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000628:therapy; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000628:therapy; D006949:Hyperlipidemias / Q000175:diagnosis / Q000628:therapy; D007348:Insurance, Health; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009939:Organizations, Nonprofit; D010358:Patient Participation; D016016:Proportional Hazards Models; D049250:Speech Recognition Software; D013689:Telephone