Effect of Reminding Patients to Complete Fecal Immunochemical Testing: A Comparative Effectiveness Study of Automated and Live Approaches
Open Access
- 10 October 2017
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of General Internal Medicine
- Vol. 33 (1), 72-78
- https://doi.org/10.1007/s11606-017-4184-x
Abstract
Background The Community Preventive Services Task Force recommends multi-component interventions, including patient reminders, to improve uptake of colorectal cancer screening. Objective We sought to compare the effectiveness of different forms of reminders for a direct-mail fecal immunochemical test (FIT) program. Design Patient-randomized controlled trial. Participants 2772 adults aged 50–75, not up to date with colorectal cancer screening recommendations, with a clinic visit in the previous year at any of four participating health center clinics. Intervention Participants were mailed an introductory letter and FIT. Those who did not complete their FIT within 3 weeks were randomized to receive (1) a reminder letter, (2) two automated phone calls, (3) two text messages, (4) a live phone call, (5) a reminder letter and a live phone call, (6) two automated phone calls and a live phone call, or (7) two text messages and a live phone call. Patients with a patient portal account were sent two email reminders, but were not randomized. Main Measures FIT return rates for each group, 6 months following randomization. Key Results A total of 255 (10%) participants returned their FIT within 3 weeks of the mailing. Among randomized participants (n = 2010), an additional 25.5% returned their FITs after reminders were delivered (estimated overall return rate = 32.7%). In intention-to-treat analysis, compared to the group allocated to receive a reminder letter, return rates were higher for the group assigned to receive the live phone call (OR = 1.51 [1.03–2.21]) and lower for the group assigned to receive text messages (OR = 0.66 [0.43–0.99]). Reminder effectiveness differed by language preference. Conclusions Our data suggest that FIT reminders that included a live call were more effective than reminders that relied solely on written communication (a text message or letter). Trial Registration: ClinicalTrials.gov/ctc2/show/NCT01742065.Keywords
This publication has 14 references indexed in Scilit:
- The validation of electronic health records in accurately identifying patients eligible for colorectal cancer screening in safety net clinicsFamily Practice, 2016
- Two-year follow-up of the effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centersCancer Causes & Control, 2015
- Comparative Effectiveness of Multifaceted Outreach to Initiate Colorectal Cancer Screening in Community Health Centers: A Randomized Controlled TrialJournal of General Internal Medicine, 2015
- Strategies and opportunities to STOP colon cancer in priority populations: pragmatic pilot study design and outcomesBMC Cancer, 2014
- A Randomized Controlled Trial to Improve Colon Cancer Screening in Rural Family Medicine: An Iowa Research Network (IRENE) StudyThe Journal of the American Board of Family Medicine, 2013
- Comparative Effectiveness of Fecal Immunochemical Test Outreach, Colonoscopy Outreach, and Usual Care for Boosting Colorectal Cancer Screening Among the UnderservedJAMA Internal Medicine, 2013
- Randomized, Controlled Trial of a Multimodal Intervention to Improve Cancer Screening Rates in a Safety-Net Primary Care PracticeJournal of General Internal Medicine, 2013
- An Automated Intervention With Stepped Increases in Support to Increase Uptake of Colorectal Cancer ScreeningAnnals of Internal Medicine, 2013
- Effectiveness of a clinic‐based colorectal cancer screening promotion program for underserved HispanicsCancer, 2010
- Healthy Colon, Healthy Life (Colon Sano, Vida Sana): Colorectal Cancer Screening Among Latinos in Santa Clara, CaliforniaJournal of Cancer Education, 2010