Patient Engagement May Not Drive Return to In-Person Visits

Patient engagement strategies appear to yield few return visits upon reopening during COVID-19 for patients who cancelled in-person care during the earlier portion of the pandemic, according to a research letter published online June 30 in JAMA Network Open.

Anne R. Cappola, M.D., from the University of Pennsylvania in Philadelphia, and colleagues conducted a randomized clinical trial to determine whether targeted messaging could improve the return to in-person visits for 11,120 adult patients who had canceled in-person appointments, procedures, or surgical procedures (March 9 through June 7, 2020) and had not rescheduled. Patients were randomly assigned to no letter versus letter (1:9), tailored versus standard letter (1:1), or electronic versus mail letter (1:1).

The researchers found that in-person return visits within one month were low and did not significantly differ between patients who did or did not receive a letter (5.0 versus 4.1 percent). However, patients receiving any letter had a significantly higher percentage of telemedicine visits and future scheduled visits within one month (telemedicine visits: 1.3 versus 0.4 percent; future visits: 14.4 versus 11.7 percent). Compared with standard letters, patients receiving the tailored letter scheduled more visits (15.3 versus 13.4 percent). Patients with a household income below the median were significantly more likely to schedule a visit when mailed a letter versus when they received an electronic letter.

"Strategies to improve patient engagement, with attention to message framing and delivery mode, are needed to encourage continuity of health care in the era of COVID-19," the authors write.