Underuse of Early Follow-up Visits: A Missed Opportunity to Improve Patients' Adherence
July 2014 | Volume 13 | Issue 7 | Original Article | 833 | Copyright © July 2014
Scott A. Davis MA,a Hsien-Chang Lin PhD,b Cheng-Han Yu MA,c
Rajesh Balkrishnan PhD,d and Steven R. Feldman MD PhDa,e,f
aDepartment of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC
bDepartment of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN
cDepartment of Applied Mathematics and Statistics, University of California, Santa Cruz, CA
dDepartment of Clinical, Social and Administrative Sciences, College of Pharmacy, University of Michigan, Ann Arbor, MI
eDepartment of Pathology, Wake Forest School of Medicine, Winston-Salem, NC
fDepartment of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
PURPOSE: To characterize the timing of first follow-up visits in US dermatologic practice.
Methods: Patients with a diagnosis of psoriasis, acne, or atopic dermatitis were identified in the 2003-2007 MarketScan Medicaid database. Factors affecting the length of time before first follow-up were assessed using a Cox proportional hazards model.
RESULTS: Mean length of time to the first follow-up visit was 153 days for adults and 142 days for children with psoriasis; 151 days for adults and 218 days for children with acne; and 161 days for adults and 209 days for children with atopic dermatitis. Black and those other than white patients were less likely than whites to receive early follow-up in psoriasis and acne, but more likely in atopic dermatitis. Dermatologists were more likely to schedule early follow-up visits than nondermatologists.
LIMITATIONS: The database includes only Medicaid patients. The rate of non-attendance at scheduled visits could not be determined.
CONCLUSIONS: Most physicians are missing the opportunity to maximize patient adherence by scheduling early follow-up visits. Contact by email or phone may be beneficial for physicians who cannot schedule early follow-up.
J Drugs Dermatol. 2014;13(7):833-836.