Predictors of Colonoscopy Non-attendance and the Efficacy of a SMS Reminder to Reduce Non-attendance Rate

Predictors of Colonoscopy Non-attendance and the Efficacy of a Short Message Service (SMS) Reminder to Reduce Non-attendance Rate: A Prospective Randomized Controlled Trial (NAC Study)

To conduct a prospective randomized controlled study to identify predictors for colonoscopy non-attendance and examine the efficacy of SMS reminder to improve the non-attendance rate.

Study Overview

• Status: Completed
• Conditions: Ultilization of Out-patient Colonoscopy Service
• Intervention / Treatment: Other: SMS reminder; Other: Non-SMS reminder

Detailed Description

Implementation of colorectal screening programs has been shown to decrease, the incidence of colorectal cancer due to the early detection and removal of pre-cancerous colonic polyps. Colonoscopy is therefore one of the most common medical procedures performed in the United States with 14 million procedures performed in 2003. Aside from screening, colonoscopy is also essential for other aspects of colorectal cancer management including post-resection surveillance and palliative treatments. Use of computer simulation models showed that the demand for colonoscopy in the United States exceeds current capacity regardless of screening strategy. The incidence of colorectal cancer has been increasing in Hong Kong and has been associated with progressive increase in the colonoscopy waiting times in the public health care system. The progressive increase in the demand for colonoscopy therefore poses a significant burden on the healthcare systems of all developed countries. Methods to increase the capacity and efficiency of the colonoscopy service are needed.

Non-attendance rates of gastrointestinal endoscopy appointments may range from 12% to 27% 5-6 and results in inefficient use of healthcare resources, delay in diagnosis and an increase in waiting times. Adams et al. conducted a prospective cohort study which showed that younger age, long waiting times and referral from a non-gastroenterologist were significantly associated with non-attendance. In an another prospective cohort study, Sola-Vera et al. also showed that the waiting time and source of referral were independent predictive factors for non-attendance 7. Studies on gynecological endoscopy non-attendance revealed that predictors of non-attendance include unemployment, current smokers, younger age, long follow up periods, lower social class, lower education levels and lack of understanding of the endoscopic procedure 8-10.

Telephone reminders have been used to improve non-attendance rates; Adams et al. had decreased the non-attendance rate from 12.2% to 9% after introduction of telephone reminder 1 week prior to the examination. The Mayo clinic open-access endoscopy system, which incorporates a standard telephone reminder 3-7 days prior to the procedure, has a non-attendance rate of only 4.1%.

• Study Type: Interventional
• Enrollment (Actual): 2225
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Hong Kong
  • Hong Kong, Hong Kong
    • Alice Ho Miu Ling Nethersole Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• All patients referred for an outpatient colonoscopy at the Alice Ho Miu Ling Nethersole Hospital Combined Endoscopy Unit

Exclusion Criteria:

• Age ≤ 18
• Lack of informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: SMS reminder; A text message reminder via Short Message Service (SMS) will be sent to remind subjects 7-10 days before his colonoscopy appointment	Other: SMS reminder; A text message reminder via Short Message Service (SMS) will be sent to remind subjects 7-10 days before his colonoscopy appointment; Other: Non-SMS reminder; No Stext message reminder via Short Message Service (SMS) will be sent
No Intervention: Non-SMS reminder; No text message reminder via Short Message Service (SMS) will be sent

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Non-attendance rate of colonoscopy	attendance of colonoscopy on the scheduled colonoscopy date	Within one year after recruitment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Predictors of colonoscopy non-attendance	different risk factors which may predicts colonoscopy non-attendance	Within one year after recruitment
Bowel preparation level	bowel preparation level of completed colonoscopy	Within one year after recruitment
Predictors of bowel preparation	different risk factors which may predicts bowel preparation level	Within one year after recruitment

Collaborators and Investigators

• Sponsor: Chinese University of Hong Kong
• Investigators: Principal Investigator: Aric Josun Hui, MD, Alice Ho Miu Ling Nethersole Hospital

Study record dates

Study Major Dates

• Study Start: November 1, 2013
• Primary Completion (Actual): October 1, 2019
• Study Completion (Actual): October 1, 2019

Study Registration Dates

• First Submitted: November 5, 2013
• First Submitted That Met QC Criteria: November 8, 2013
• First Posted (Estimate): November 15, 2013

Study Record Updates

• Last Update Posted (Actual): April 9, 2020
• Last Update Submitted That Met QC Criteria: April 7, 2020
• Last Verified: April 1, 2020

More Information

Terms related to this study

• Other Study ID Numbers: NAC Study