Improving adherence to hysterosalpingography after hysteroscopic sterilization using an electronic reminder

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery
• Medical Informatics

Background:

• US package labeling for the Essure system mandates hysterosalpingography (HSG) for confirmatory testing.
• Previous strategies to improve HSG adherence include patient tracking protocols.
• Ensuring proper Essure device placement and tubal occlusion is critical for sterilization efficacy.

Purpose of the Study:

• To evaluate the impact of an electronic staff reminder system on post-Essure HSG adherence.
• To determine if electronic reminders can enhance compliance with mandatory confirmatory testing.

Main Methods:

• Retrospective cohort study of 211 patients who underwent the Essure procedure between January 2005 and January 2012.
• Inclusion of patients from a university-affiliated hospital setting.
• Implementation of an electronic reminder system for office staff as the primary intervention.

Main Results:

• The odds of post-Essure HSG adherence showed a statistically significant increase of nearly 3-fold in the resident clinic population (OR = 2.9; p = .003).
• Overall and faculty practice patient populations did not demonstrate statistically significant increases in HSG adherence.
• The study analyzed adherence rates before and after the electronic reminder implementation.

Conclusions:

• Implementation of an electronic reminder system is effective in increasing post-Essure HSG adherence.
• The positive impact was specifically observed within the resident clinic patient population.
• Electronic reminders represent a viable strategy to improve adherence to essential follow-up procedures in gynecologic care.