Effect of Reminding Patients to Complete Fecal Immunochemical Testing: A Comparative Effectiveness Study of Automated and Live Approaches

Abstract

BackgroundThe Community Preventive Services Task Force recommends multi-component interventions, including patient reminders, to improve uptake of colorectal cancer screening.ObjectiveWe sought to compare the effectiveness of different forms of reminders for a direct-mail fecal immunochemical test (FIT) program.DesignPatient-randomized controlled trial.Participants2772 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.InterventionParticipants 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 MeasuresFIT return rates for each group, 6 months following randomization.Key ResultsA 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.ConclusionsOur 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.

Effectiveness of a brief phone intervention to increase participation in a population‐based colorectal cancer screening programme: a randomized controlled trial

“…In our study, 49 (19%) intended recipients could not be contacted (19%). This rate is similar to other studies [10,12,36]. The reason for non-contact may reflect their demographics in which case it would be useful to identify them.…”

“…This increase may in part be due to the low (5.9%) participation rate of the control group which, unlike our study, had not received any information. Our participation rate was similar to other studies involving phone interventions .…”

“…Coronado et al . reported that personal telephone call reminders were more effective than written reminders (31.8% vs 23.7%) . In another study, personal phone call reminders plus a reminder letter increased participation by 9% compared to reminder letter alone (27.5% vs 17.8%) .…”

“…Phillips et al found that the combination of letters and automated telephone reminders improved participation rates compared with letters or automated phone reminders alone (24% both interventions vs 17% letters vs 14% phone reminders, P < 0.05) [22]. Coronado et al reported that personal telephone call reminders were more effective than written reminders (31.8% vs 23.7%) [10]. In another study, personal phone call reminders plus a reminder letter increased participation by 9% compared to reminder letter alone (27.5% vs 17.8%) [11].…”

Effectiveness of a short message service intervention to motivate people with positive results in preliminary colorectal cancer screening to undergo colonoscopy: A randomized controlled trial

“…In Baker et al’s study in Chicago in the United States, text messages integrated with a mailed reminder letter, low‐literacy instruction, and telephone calls effectively improved FOBT screening. In Coronado et al’s study in Washington in the United States, text messages were not as effective as live calls at improving CRC screening. Nonetheless, there is very limited evidence of the effects of SMS in promoting colonoscopy .…”