Background
A randomized controlled trial was undertaken to measure the efficacy of a patient reminder system for females age 40 – 75 in a Midwestern primary care practice. A subset of the population whose email addresses were known was further randomized to measure the effect of email versus postal reminders. A statistically significant increase in completion rates was observed in the intervention group while no difference was found between the email and postal mail groups.
Objective
To assess the relative effectiveness of e-mail versus letter reminders to women due for mammogram screening.
Data Sources/Study Setting
Patient registration and claims data were used to determine patient eligibility. The patient intervention in this randomized control trial was carried out from 10/2003 to 10/2004.
Study Design
Women aged 40–75 who had not had mammography screening in the previous 9 months were randomly assigned to either a) be sent a reminder about breast cancer screening with a phone number to schedule an appointment or b) receive no reminder. Women who were employees of the medical center who were randomized to receive a reminder were further randomized to receive the reminder a) by mail or b) by e-mail. The effectiveness of the trial was assessed by the percent of women in each group who were up-to-date on mammography screening at the end of the trial
Data Collection/Extraction Method
Women eligible for screening were identified from patients in primary care panels who had not had mammograms performed within the system in the prior nine months. Reminders were sent out to those in the intervention arm. Women who did not schedule a mammogram were reminded again in 4–6 weeks. Administrative data covering from 1/2002 to 10/2004 was processed to determine whether mammograms had been performed.
Principal Findings
Women who received reminders had screening rates significantly higher than those who did not receive reminders (64.3% vs. 55.3%; p<0.001). Among the subset of employees, there was no significant difference between those with postal versus e-mail reminders (postal: 68.1%, 95% CI: 63.7 – 72.4%; e-mail: 72.2%, 95% CI: 67.8–76.6%.
Conclusion
Reminding women to receive timely preventive services increases the rate at which they have them completed, particularly for mammography screening. Among those with e-mail availability at work, there appears to be no significant difference if the reminder is mailed to their home or e-mailed to their work address.