N/A N=3,610 Randomized Single-blind Health Services Research

Use of Telehealth In-home Messaging to Improve GI (Gastrointestinal) Endoscopy Completion Rates

Colorectal Cancer

Bottom Line

View on ClinicalTrials.gov: NCT00310362 ↗

Enrolled (actual)

3,610

Serious AEs

—

Results posted

Sep 2014

Primary outcome: Primary: Appointment Nonadherence-colonoscopy — 348; 333; 303 Participants

Study Design & Population

Study type: Interventional
Phase: N/A
Interventions: Use of Interactive Voice Response (IVR) system to improve adherence to GI appointments and prep procedures (Behavioral)
Age: Pediatric, Adult, Older Adult
Sex: All
Sponsor: VA Office of Research and Development
Primary completion: Jan 2009

Outcome Measures

Outcome	Result	p-value
PRIMARY Appointment Nonadherence-colonoscopy	348; 333; 303	—
SECONDARY Nonattendance-flexible Sigmoidoscopy	155; 169; 164	—
SECONDARY Preparation Nonadherence-colonoscopy	348; 349; 319	—
SECONDARY Preparation Non-adherence-flexible Sigmoidoscopy	164; 173; 168	—

Summary

Low endoscopy completion rates are a major problem in the VA, causing delay or failure to receive essential care, increased clinic wait times, lost capacity, increased costs, thus limiting endoscopic screening for colorectal cancer. This study tests whether an Interactive Voice Response (IVR) messaging system is equally effective in promoting the completion of flexible sigmoidoscopy and colonoscopy as usual clinical care practices that include phone calls from nurses to patients prior to preparation and procedures. Previous studies have examined the role of scheduling facilitation or patient adherence on endoscopy completion and the use of IVR technology to enhance patient adherence in other medical contexts. This is the first study, however, to evaluate the use of IVR for endoscopy completion and the first to compare it to the effectiveness of phone calls from nurses prior to an endoscopy appointment.

Eligibility Criteria

Inclusion Criteria

All patients with either flexible sigmoidoscopy or colonoscopy appointments scheduled greater than 7 days before their appointment in the GI endoscopy clinic from August 20, 2007 through October 31, 2008.

Exclusion Criteria

Patients were not considered eligible for inclusion in the study if, based on a medical record review prior to randomization, they had unreliable means of receiving the intervention or the intervention would have provided inappropriate or inaccurate information. These patients included those who lived in a nursing or group home or homeless shelter; had no listed telephone number; scheduled the appointment less than 8 days in advance; or, had Type 1 diabetes, dementia or Alzheimer's or multiple GI procedures on the same day (such as those with both upper and lower GI procedures). All patients excluded from the study were assigned to usual care.

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Data sourced from ClinicalTrials.gov (NCT00310362). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.