Overcoming Poor Attendance to First Scheduled Colonoscopy: A Randomized Trial of Peer Coach or Brochure Support

Abstract

Among patients unlikely to attend a scheduled colonoscopy, we examined the impact of peer coach versus educational brochure support and compared these with concurrent patients who did not receive support. From health system data, we identified 275 consecutive patients aged >50 who kept N = 70) and brochure group (N = 66) differed by 11% (68.6% vs 57.6%, respectively). Compared with the brochure group, the peer coach group had over twofold greater adjusted odds ratio (AOR) of attendance (2.14, 95% confidence interval [CI] = 0.99–4.63) as did 49 patients who met the prespecified criteria for needing no support (2.68, 95%CI = 1.05–6.82) but the AORs did not differ significantly for 41 patients who declined support (0.61, 95%CI = 0.25–1.45) and 49 patients who could not be contacted (0.85, 95%CI = 0.36–2.02). Attendance was less likely for black versus white race (AOR = 0.37, 95%CI = 0.19–0.72) but more likely for patients with high versus low primary care visit adherence (AOR = 2.30, 95%CI = 1.04–5.07). For patients who often fail to keep appointments, peer coach support appears to promote colonoscopy attendance more than an educational brochure.