Colorectal Cancer Clinical Trial
Official title:
Repeated Automated Mobile Text Reminders for Follow-up of Positive Fecal Occult Blood Tests: a Randomized Controlled Trial
A randomized controlled trial to examine the effect of 3 mobile telephone text message reminders on followup colonoscopy 120 days after a positive fecal occult blood test among Meuhedet members aged 50-74 who tested positive in 2016.
Background: Fecal occult blood tests are recommended by the US Preventive Services Task Force
as a screening method for colorectal cancer, but they are only effective if positive results
are followed by colonoscopy. Surprisingly, a large proportion of patients with a positive
result do not follow this recommendation.
Objective: To examine the effectiveness of a short message service in increasing adherence to
colonoscopy follow-up after a positive fecal occult blood test.
Methods: This randomized controlled trial was conducted with patients who had positive
colorectal cancer screening results. Randomization was stratified by residential district and
socioeconomic status. Subjects in the control group (n = 238) received routine care that
included an alert to the physician regarding the positive Fecal occult blood test result. The
intervention group (n = 232) received routine care and three short message service reminders
to visit their primary care physician. Adherence to colonoscopy was measured 120 days from
the positive result. All patient information, including test results and colonoscopy
completion, were obtained from their computerized medical records. Physicians of the study
patients completed an attitude survey regarding FOBT as a screening test for colorectal
cancer. The intervention and control groups were compared using chi-squared for discrete
variables. Logistic regression was used to calculate odds ratios and 95% confidence intervals
for performing colonoscopy within 120 days, adjusting for potential confounders of age,
gender, socioeconomic status, district, ethnicity, intervention group and physician's
attitude.
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