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Research ArticleOriginal Research

Having a Primary Care Provider is the Strongest Predictor of Successful Follow-up of Participants in a Clinical Trial

Samuel H. Friedman, Chinazo O. Cunningham, Juan Lin, Linda B. Haramati and Jeffrey M. Levsky
The Journal of the American Board of Family Medicine May 2020, 33 (3) 431-439; DOI: https://doi.org/10.3122/jabfm.2020.03.190018
Samuel H. Friedman
From Department of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (SHF, LBH, JML); Department of Family and Social Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (COC); Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (COC, LBH, JML); Department of Epidemiology & Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (JL); Current Address: Department of Family Medicine, Overlook Medical Center, Summit, NJ (SHF).
MD
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Chinazo O. Cunningham
From Department of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (SHF, LBH, JML); Department of Family and Social Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (COC); Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (COC, LBH, JML); Department of Epidemiology & Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (JL); Current Address: Department of Family Medicine, Overlook Medical Center, Summit, NJ (SHF).
MD, MS
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Juan Lin
From Department of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (SHF, LBH, JML); Department of Family and Social Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (COC); Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (COC, LBH, JML); Department of Epidemiology & Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (JL); Current Address: Department of Family Medicine, Overlook Medical Center, Summit, NJ (SHF).
PhD
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Linda B. Haramati
From Department of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (SHF, LBH, JML); Department of Family and Social Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (COC); Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (COC, LBH, JML); Department of Epidemiology & Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (JL); Current Address: Department of Family Medicine, Overlook Medical Center, Summit, NJ (SHF).
MD, MS
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Jeffrey M. Levsky
From Department of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (SHF, LBH, JML); Department of Family and Social Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (COC); Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (COC, LBH, JML); Department of Epidemiology & Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (JL); Current Address: Department of Family Medicine, Overlook Medical Center, Summit, NJ (SHF).
MD, PhD
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Article Figures & Data

Tables

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    Table 1.

    Patient Baseline Characteristics (n = 400)

    CharacteristicValues*
    Age (y)57 ± 11
    BMI (kg/m2)†31 ± 6.4
    SES‡−3.95 (−6.58, −1.55)
    Gender
        Men148 (37.0%)
        Women252 (63.0%)
    Ever smoked
        Yes169 (42.3%)
        No231 (57.8%)
    Current smoker
        Yes59 (14.8%)
        No341 (85.3%)
    Diabetes
        Yes127 (31.8%)
        No273 (68.3%)
    Hypertension
        Yes288 (72.0%)
        No112 (28.0%)
    Dyslipidemia
        Yes206 (51.5%)
        No194 (48.5%)
    PCP§
        Yes350 (87.5%)
        No50 (12.5%)
    Close Contact
        Yes359 (89.8%)
        No41 (10.3%)
    Number of phone numbers2 (2, 3)
    Charlson score0 (0, 1)
    Interpreter used
        Yes103 (25.85)
        No297 (74.3%)
    Native Language
        English204 (51.0%)
        Non-English196 (49.0%)
    Race
        Asian18 (4.5%)
        Black143 (35.8%)
        Hispanic215 (53.8%)
        Multiracial6 (1.5%)
        White18 (4.5%)
    Insurance
        Commercial118 (29.5%)
        Medicaid177 (44.3%)
        Medicare98 (24.5%)
        Self pay7 (1.8%)
    • ↵* Categorical variables are presented as frequencies and percentages. Continuous variables are presented as either means and standard deviations or medians and interquartile ranges, depending on distribution.

    • ↵† BMI, body mass index.

    • ↵‡ SES, socioeconomic score. Displayed as a Z score calculated based on the person's address and 6 socioeconomic variables for the neighborhood by zip code (log of median household income; log of median value of housing units; the percentage of households receiving interest, dividend, or net rental income; education; the percentage of adults who completed college; and the percentage of employed individuals in executive, managerial or professional positions) and normalized to the New York State average.

    • ↵§ PCP, primary care physician.

    • View popup
    Table 2.

    Bivariate Analysis of Independent Risk Factors for Loss of Follow-up*

    FactorNo One-Year Follow-up (n = 19)Successful One-Year Follow-up (n = 381)P Value
    Age (y)56 ± 1057 ± 11.7512
    BMI (kg/m2)†29 ± 6.731 ± 6.4.1862
    SES‡−3.1371 (−6.56945, −1.675089)−3.9734 (−6.6542, −1.647682).5627
    Gender.0532
        Men11 (57.9%)137 (36.0%)
        Women8 (42.1%)244 (64.0%)
    Ever smoked.6435
        Yes9 (47.4%)160 (42.0%)
        No10 (52.6%)221 (58.0%)
    Current smoker.5025
        Yes4 (21.1%)55 (14.4%)
        No15 (78.9%)326 (85.6%)
    Diabetes.4493
        Yes4 (21.1%)123 (32.3%)
        No15 (78.9%)258 (67.7%)
    Hypertension.7218
        Yes13 (68.4%)275 (72.2%)
        No6 (31.6%)106 (27.8%)
    Dyslipidemia.1902
        Yes7 (36.8%)199 (52.2%)
        No12 (63.2%)182 (47.8%)
    PCP§.0010
        Yes13 (68.4%)337 (88.5%)
        No6 (31.6%)44 (11.5%)
    Close contact.7071
        Yes18 (94.7%)341 (89.5%)
        No1 (5.3%)40 (10.5%)
    Number of phone numbers2 (2, 2)2 (2, 3).4856
    Charlson score0 (0, 1)1 (0, 1).0480
    Interpreter used.2572
        Yes7 (36.8%)96 (25.2%)
        No12 (63.2%)285 (74.8%)
    Native Language.0274
        English5 (26.3%)199 (52.2%)
        Non-English14 (73.7%)182 (47.8%)
    Race.4468
        Asian0 (0.0%)18 (4.7%)
        Black4 (21.1%)139 (36.5%)
        Hispanic14 (73.7%)201 (52.8%)
        Multiracial0 (0.0%)6 (1.6%)
        White1 (5.3%)17 (4.5%)
    Insurance.9068
        Commercial5 (26.3%)113 (29.7%)
        Medicaid10 (52.6%)167 (43.8%)
        Medicare4 (21.1%)94 (24.7%)
        Self pay0 (0.0%)7 (1.8%)
    • ↵* Categorical variables are presented as frequencies and percentages. Continuous variables are presented as either means and standard deviations or medians and interquartile ranges, depending on distribution.

    • ↵† BMI, body mass index.

    • ↵‡ SES, socioeconomic score. Displayed as a Z score as in the previous table.

    • ↵§ PCP, primary care physician.

    • View popup
    Table 3.

    Logistic Regression Analysis of Factors Associated with Successful Follow-up

    FactorOdds Ratio (95% CI)P Value
    PCP,* Yes3.487 (1.247–9.753).0173
    Native Language, English3.030 (1.063–8.621).0381
    • ↵* PCP, primary care physician; CI, confidence interval.

    • View popup
    Table 4.

    Bivariate Analysis of Independent Variables for Achieving Complete Follow-up*

    Variable% Follow up 1st Tertile% Follow up 2nd Tertile% Follow up 3rd TertileP Value
    Possible Follow-up (days)1,359 ± 3781,391 ± 3771,446 ± 376.1289
    Age (y)55 ± 11.260 ± 10.955 ± 10.9.0016
    BMI (kg/m2)†31 ± 7.231 ± 6.330 ± 5.8.9513
    SES‡−4.211−4.0430−4.0625.8651
    Gender.0019
        Women71 (53.4%)100 (74.1%)81 (61.4%)
        Men62 (46.6%)35 (25.9%)51 (38.6%)
    Ever smoked.2245
        No83 (62.4%)73 (54.1%)75 (56.8%)
        Yes50 (37.6%)62 (45.9%)57 (43.2%)
    Current smoker.6544
        No115 (86.5%)112 (83.0%)114 (86.4%)
        Yes18 (13.5%)23 (17.0%)18 (13.6%)
    Diabetes.0191
        No99 (74.4%)80 (59.3%)94 (71.2%)
        Yes34 (25.6%)55 (40.7%)38 (28.8%)
    Hypertension.2592
        No42 (31.6%)31 (23.0%)39 (29.5%)
        Yes91 (68.4%)104 (77.0%)93 (70.5%)
    Dyslipidemia.0027
        No69 (51.9%)32 (30.5%)63 (47.7%)
        Yes64 (48.1%)73 (69.5%)69 (52.3%)
    PCP§.0046
        No24 (18.0%)7 (5.2%)19 (14.4%)
        Yes109 (82.0%)128 (94.8%)113 (85.6%)
    Close contact.2400
        No9 (6.8%)15 (11.1%)17 (12.9%)
        Yes124 (93.2%)120 (88.9%)115 (87.1%)
    Number of phone numbers2 (2, 3)2 (2, 3)2 (2, 3).3205
    Charlson score0 (0, 1)1 (0, 2)1 (0, 1).5851
    Interpreter used.9130
        No97 (72.9%)101 (74.8%)99 (75.0%)
        Yes36 (27.1%)34 (25.2%)33 (25.0%)
    Native language.2019
        English67 (50.4%)62 (45.9%)75 (56.8%)
        Non-English66 (49.6%)73 (54.1%)57 (43.2%)
    Race.4560
        Asian4 (3.0%)6 (4.4%)8 (6.1%)
        Black49 (36.8%)44 (32.6%)50 (37.9%)
        Hispanic72 (54.1%)77 (57.0%)66 (50.0%)
        Multiracial2 (1.5%)4 (29.6%)0 (0.0%)
        White6 (4.5%)4 (29.6%)8 (6.1%)
    Insurance.0619
        Commercial49 (36.8%)29 (21.5%)40 (30.3%)
        Medicaid51 (38.3%)58 (43.0%)68 (51.5%)
        Medicare29 (21.8%)48 (35.6%)21 (15.9%)
        Self pay4 (3.0%)0 (0.0%)3 (2.3%)
    • ↵* For each bivariate analysis, % follow-up complete was divided into tertiles. Categorical variables are presented as frequencies and percentages. Continuous variables are presented as either means and standard deviations or medians and interquartile ranges, depending on distribution.

    • ↵† BMI, body mass index.

    • ↵‡ SES, socioeconomic score. Displayed as a Z score as in the previous table.

    • ↵§ PCP, primary care physician.

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The Journal of the American Board of Family     Medicine: 33 (3)
The Journal of the American Board of Family Medicine
Vol. 33, Issue 3
May/June 2020
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Having a Primary Care Provider is the Strongest Predictor of Successful Follow-up of Participants in a Clinical Trial
Samuel H. Friedman, Chinazo O. Cunningham, Juan Lin, Linda B. Haramati, Jeffrey M. Levsky
The Journal of the American Board of Family Medicine May 2020, 33 (3) 431-439; DOI: 10.3122/jabfm.2020.03.190018

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Having a Primary Care Provider is the Strongest Predictor of Successful Follow-up of Participants in a Clinical Trial
Samuel H. Friedman, Chinazo O. Cunningham, Juan Lin, Linda B. Haramati, Jeffrey M. Levsky
The Journal of the American Board of Family Medicine May 2020, 33 (3) 431-439; DOI: 10.3122/jabfm.2020.03.190018
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