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J Knee Surg 2021; 34(02): 130-136
DOI: 10.1055/s-0039-1694057
Original Article

A Last-Ditch Effort and Personalized Surgeon Letter Improves PROMs Follow-Up Rate in Sports Medicine Patients: A Crossover Randomized Controlled Trial

Muhammad B. Tariq
1   Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
2   Cleveland Clinic Orthopaedic Sports Medicine, Cleveland, Ohio
,
Morgan H. Jones
2   Cleveland Clinic Orthopaedic Sports Medicine, Cleveland, Ohio
,
Greg Strnad
2   Cleveland Clinic Orthopaedic Sports Medicine, Cleveland, Ohio
,
Elizabeth Sosic
2   Cleveland Clinic Orthopaedic Sports Medicine, Cleveland, Ohio
,
Cleveland Clinic OME Sports Health,
Kurt P. Spindler  
2   Cleveland Clinic Orthopaedic Sports Medicine, Cleveland, Ohio
› Author Affiliations
Funding The research reported in this publication was partially supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Number R01AR053684 (KPS) and under award number K23AR066133, which supported a portion of M .H. J.'s professional effort.
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Abstract

Patient-reported outcomes measures (PROMs) are important for the advancement of orthopaedic surgeries. The primary difficulty while collecting PROMs is obtaining adequate follow-up rates. Therefore, it is important to find methods to improve follow-up, especially in patients who have failed to respond to initial attempts. We hypothesized that PROMs follow-up could be effectively increased by sending a salvage-effort personalized surgeon letter to sports medicine patients who failed to respond to initial (centralized electronic, mail, and/or phone contacts) PROMs collection 1 year after surgery. Patients who failed to respond to 1-year follow-up of postoperative PROMs collection at our outpatient sports medicine surgery center were included. Patients were randomized into an intervention or control group. Patients in the intervention group were mailed PROMs form and an Institutional Review Board-approved letter that was personalized with surgical information, surgeon picture, and surgeon signature. Control group was mailed the same letter a month later. Chi-squared analysis was conducted at 5 weeks. Out of 843 surgeries, our initial 1-year PROMs follow-up rate was 65%, which allowed for 292 patients to be eligible for our study. After exclusions, 281 patients (randomized to 140 control group and 141 intervention group) were included in our study. We found a 20% response rate in the intervention group with 28 patients returning PROMs as compared with a 1.4% rate in the control group with two patients returning PROMs. The odds ratio was 17.1 (95% confidence interval: 4–73.3; p < 0.0001). A salvage-effort personalized surgeon letter is an efficient and relatively cost-effective method to increase PROMs follow-up rate, which means that a personalized surgeon letter can reach and engage patients who would otherwise be considered lost to follow-up, allowing for better outcomes monitoring after surgery.

Keywords

patient follow-up - patient-reported outcomes - PROMs - postoperative follow-up - sports medicine

Corporate Authorship: * Cleveland Clinic OME Sports Health: Peter Evans, MD, PhD; Lutul Farrow, MD; Ryan Goodwin, MD; Morgan H. Jones, MD, MPH, Anthony Miniaci, MD; Richard Parker, MD; James Rosneck, MD; Paul Saluan, MD; Mark Schickendantz, MD, Kurt P. Spindler, MD.




Publication History

Received: 15 August 2018

Accepted: 18 June 2019

Article published online:
07 August 2019

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