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Ramon Velez, MD; Lynda Anderson, PhD; Stephanie McFall, MA; Kathryn Magruder-Habib, PhD

Arch Intern Med. 1985;145(12):2184-2187.

Abstract
• The effects of referral letters on increasing the likelihood of patients obtaining hypertension follow-up assessments are presented. Seventy-four patients with elevated diastolic blood pressure (between 95 and 120 mm Hg), who were administratively ineligible for longitudinal care from the Veterans Administration, were randomized into one of four groups: a patient letter; a physician letter; both patient and physician letters; or no letter (control group). No evidence of interaction between the patient and physician letters was found. Results revealed that nearly twice as many patients (63%) receiving the patient letter returned for a hypertension evaluation as compared with those who did not (33%). No difference was found between the physician letter and no physician letter conditions. These findings suggest that patient-directed referral letters can increase the likelihood of follow-up in both previously detected and newly detected cases.

(Arch Intern Med 1985;145:2184-2187)

Author Affiliations
From the Health Services Research and Development Program, Veterans Administration Medical Center (Drs Velez, Anderson, and Magruder-Habib, and Ms McFall), and the Department of Community and Family Medicine, Duke University Medical Center (Dr Magruder-Habib), Durham, NC. Dr Velez is now with the Department of Medicine, University of Texas Health Science Center, San Antonio; Dr Anderson is now a fellow with the Center for Aging and Human Development, Duke University Medical Center.

Footnotes
Accepted for publication Feb 27, 1985.

Reprint requests to Department of Medicine, Division of General Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78234 (Dr Velez).

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ABSTRACT