Short Message Service reminders reduce outpatient colonoscopy nonattendance rate: A randomized controlled study

Abstract

Background and Aim: Nonattendance of outpatient colonoscopy leads to inefficient use of health-care resources. We aimed to study the effectiveness of using Short Message Service (SMS) reminder prior in patients scheduled for outpatient colonoscopy on their nonattendance rate. Methods: Patients who scheduled for an outpatient colonoscopy and had access of SMS were recruited from three clinics in Hong Kong. Patients were randomized to SMS group and standard care (SC) group. All patients were given a written appointment slip on the booking date. In addition, patients in the SMS group received an SMS reminder 7-10 days before their colonoscopy appointment. Patients' demographics, attendance, colonoscopy completion, and bowel preparation quality were recorded. Logistic regression was performed to identify predictors of nonattendance. Results: From November 2013 to October 2019, a total of 2225 eligible patients were recruited. A total of 1079 patients were allocated to the SMS group and 1146 to the SC group. The nonattendance rate of patients in the SMS group was significantly lower than that in the SC group (8.9% vs 11.9%, P = 0.022). There were no significant differences in their baseline characteristics and colonoscopy completion rate and bowel preparation quality. A trend towards a higher rate of adequate bowel preparation was observed in the SMS group when compared with the SC group (69.9% vs 65.8%, P = 0.053). Independent predictors for nonattendance included younger age, underprivilege, and existing diabetes. Conclusions: An SMS reminder for outpatient colonoscopy is effective in reducing the nonattendance rate and may potentially improve the bowel preparation quality.

An appointment lead time of more than two weeks is significantly associated with not presenting for a liver biopsy procedure

“…Patients who are on long waiting lists may forget their appointments. This result supports the use of appointment reminders by phone [13] or text message, [14] which have been shown to increase attendance rates for endoscopy units appointments. Moreover, patients may think that they do not need the procedure because their complaints subside during the waiting period.…”

Supplementary education can improve the rate of adequate bowel preparation in outpatients: A systematic review and meta-analysis based on randomized controlled trials

“…As shown in Table 2 , as the primary outcome, all studies (n = 21) reported adequate bowel preparation rates. Eleven of the studies [ 12 , 13 , 16 , 18 , 19 , 22 – 24 , 33 , 34 , 37 ] were in the low-ratio group(the adequate bowel preparation rate in the control group was less than 70%), and the remaining ten studies [ 7 , 14 , 15 , 17 , 20 , 21 , 32 , 35 , 36 , 38 ] were in the high-ratio group (the adequate bowel preparation rate in the control group reached or exceeded 70%) ( Table 2 ). As shown in Fig 3 , supplemental education increased adequate bowel readiness by 10.47% (60.53% to 71.9%, p< 0.00001) in the low-ratio group, but only 4.53% (82.67% to 87.20, p = 0.003) in the high-ratio group.…”

“…The analysis of nine studies [ 12 , 14 , 16 , 23 , 24 , 33 , 35 – 37 ] completed in the USA shows that supplementary education can significantly improve the rate of adequate bowel preparation for outpatients (72.1% vs 67.6%, RR:1.09, 95% CI: 1.01 to 1.19, I 2 = 65%, p = 0.03) ( S6B Fig ). A subgroup analysis based on studies in China [ 7 , 15 , 18 , 19 , 22 , 32 , 34 ] (RR:1.19, 95% CI: 1.10 to 1.28, I 2 = 78%, p <0.00001) and Spain [ 17 , 20 , 21 ] (RR:1.03, 95%CI: 1.01 to 1.06, I 2 = 0%, p = 0.007) also showed that supplementary education can significantly increase the rate of adequate bowel preparation (China: 78.7% vs 68.7% and Spain: 88.8% vs 85.8%) ( S6B Fig ).…”

“…Subgroup analysis based on video [ 14 – 16 , 34 ] (RR:1.21, 95% CI: 0.98 to 1.48, I 2 = 90%, p = 0.07), short message [ 22 – 24 ] (RR:1.05, 95% CI: 0.97 to 1.13, I 2 = 23%, p = 0.24) and smartphone application [ 17 , 18 , 32 ] (RR:1.10, 95% CI: 0.99 to 1.22, I 2 = 90%, p = 0.09) as a supplementary educational method showed that there was no significant difference in the adequate bowel preparation rate between the two groups of outpatients ( S6E Fig ). The results of four telephone call [ 7 , 19 – 21 ] (86.0% vs 79.6%, RR:1.12, 95% CI: 1.01 to 1.25, I 2 = 84%, p = 0.03) and two booklet [ 12 , 13 ] (80.5% vs 51.3%, RR:1.60, 95% CI: 1.15 to 2.23, I 2 = 89%, p = 0.006) studies showed that supplementary education can significantly improve the rate of adequate bowel preparation for outpatients ( S6E Fig ).…”

“…To increase the awareness of bowel preparation in outpatients and improve compliance, researchers have made extensive attempts. Examples included cartoon education booklets [ 12 , 13 ], educational videos [ 14 – 16 ], smartphone applications [ 17 , 18 ], telephone communication [ 7 , 19 – 21 ] and message reminders [ 22 – 24 ]. A recent meta-analysis showed that multimedia education can increase the rate of adequate bowel preparation and the detection rate of adenomas during colonoscopy [ 25 ].…”