Non-Attendance to Post-Radiotherapy Follow-Up in Breast Cancer: Efficacy of Mail and Telephone Reminders

Background: To assess the efficacy of two reminder interventions in improving post-radiotherapy followup attendance rates of breast cancer patients. Methods: Three periods of three months were assessed, a baseline period, an intervention period and a confirmation period. In the intervention period, a two-step reminder system was used. This system consisted of a mail reminder (IV1) that was sent to all patients three to four weeks prior to the post-radiotherapy follow-up visit, which was followed by up to two telephone calls (IV2) for all patients who did not attend this follow-up visit. During the confirmation period, IV2 was used exclusively to assess the maximal possible efficacy of the telephone reminder. Results: The non-attendance rate of breast cancer patients was 18.1% (19/105) in the baseline period; this rate decreased to 13.1% in the intervention period (23/176; p=0.33) after IV1 and then decreased to 6.3% (11/176; p=0.03) after IV2. In the confirmation period, 24.4% (42/172) of breast cancer patients did not attend their post-radiotherapy follow-up visit; the non-attendance rate decreased significantly after (exclusive) IV2 from 24.4% (42/172) to 9.3% (16/172; p<0.001). Significance was observed for the first call but not for the second call in the chi-square test. Conclusion: Telephone reminder is an effective tool for improving breast cancer patient adherence to the post-radiotherapy follow-up visit. In this study, the telephone reminder system was more effective than the mail reminder system.