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
