Automated Navigation to Improve Outpatient Colonoscopy Adherence

Status Completed

Clinical Trial Summary

Outpatient colonoscopy adherence is negatively impacted by poor communication and challenges with bowel preparation. We plan to perform a randomized controlled trial at the Pennsylvania Presbyterian Medical Center to (1) provide text message-based educational and reminder messages to patients regarding a scheduled colonoscopy, and (2) evaluate the impact of the texting intervention on colonoscopy show rate and bowel preparation.

Clinical Trial Description

Colorectal cancer (CRC) is the second leading cause of cancer death in the US, yet there are effective screening and treatment strategies that allow for early detection and treatment. CRC screening is recommended for all individuals aged 50-75, which could include stool testing or colonoscopy, but national rates are still suboptimal at 59-65%. Colonoscopy is an essential component of CRC screening, as it is also required if stool testing is positive. However, colonoscopy requires a complex process to identify an escort, purchase the preparation, take a day off from work, adhere to a clear liquid diet, and complete the split-dose preparation as recommended. This results in a significant no-show and cancellation rate, along with suboptimal preparation quality, which can lead to non-adherence and incomplete screening.

Current approaches to engaging patients include having nurses call patients before the procedure or patient navigators. However, it is often difficult to get patients on the phone, and these interventions can be costly, making it less scalable for clinical practices. Other interventions such as videos or mobile apps have been limited by poor user experience or limited engagement with the patient. There is an opportunity to leverage an automated text message navigation intervention using the Way to Health (WTH) platform to improve patient engagement prior to colonoscopy completion. The WTH platform is a Penn Medicine platform that is hosted on site at the University of Pennsylvania. The platform allows custom text messages to automatically be sent to patients, in addition to bidirectional message capabilities. WTH is protected by a secure firewall and is a HIPAA compliant platform.

In the past year, our team conducted a quality improvement pilot initiative using WTH that tested the feasibility and impact of a one-week text messaging protocol for patients who were scheduled for outpatient colonoscopy. The text messages sent to patients contained information about the preparation process and instructions, expectations about the procedure, and reminders about location and timing. Among the 21 patients enrolled in the pilot, we found high user acceptability and higher colonoscopy show rates as compared to baseline values at Pennsylvania Presbyterian Medical Center. As such we believe that the texting intervention is feasible for testing in the context of a randomized controlled trial. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT03710213
Study type	Interventional
Source	University of Pennsylvania
Contact
Status	Completed
Phase	N/A
Start date	November 26, 2018
Completion date	September 18, 2019

View Details

See also
Status	Clinical Trial	Phase
Completed	`NCT04101097` - Training and Validation of Models of Factors to Predict Inadequate Bowel Preparation Colonoscopy
Completed	`NCT03247595` - Testing How Well Magnesium Citrate Capsules Work as Preparation for a Colonoscopy	N/A
Completed	`NCT04214301` - An Open-Label Preference Evaluation of BLI800	Phase 4
Withdrawn	`NCT05754255` - Comparison of High-flow Oxygen With or Without Nasal Positive Airway Pressure (PAP) During Propofol Sedation for Colonoscopy in an Ambulatory Surgical Center	N/A
Recruiting	`NCT02484105` - Comforting Conversation During Colonoscopy: A Trial on Patient Satisfaction	Phase 4
Active, not recruiting	`NCT02264249` - Residual Gastric Volume in Same Day Versus Split Dose and Evening Before Bowel Preparation	N/A
Terminated	`NCT01978509` - The Affect of Low-Volume Bowel Preparation for Hospitalized Patients Colonoscopies	N/A
Completed	`NCT01964417` - The Comparative Study Between Bowel Preparation Method	Phase 3
Recruiting	`NCT01685970` - Comparison of Same-day 2 Sachets Picosulfate Versus High Volume PEG for Afternoon Colonoscopy	Phase 3
Completed	`NCT01518790` - Short Course, Single-dose PEG 3350 for Colonoscopy Prep in Children	N/A
Recruiting	`NCT00748293` - Achievement of Better Examinee Compliance on Colon Cleansing Using Commercialized Low-Residue Diet	N/A
Completed	`NCT00779649` - MoviPrep® Versus HalfLytely®, Low-VolUme PEG Solutions for Colon Cleansing: An InvesTigator-blindEd, Randomized, Trial	Phase 4
Completed	`NCT00671177` - Clinical Evaluation of Water Immersion Colonoscopy Insertion Technique	N/A
Completed	`NCT00380497` - Pico-Salax Versus Poly-Ethylene Glycol for Bowel Cleanout Before Colonoscopy in Children	Phase 4
Recruiting	`NCT00160823` - Impact of a Self-Administered Information Leaflet on Adequacy of Colonic Cleansing for in-Hospital Patients	Phase 3
Completed	`NCT00314418` - Patient Position and Impact on Colonoscopy Time	N/A
Completed	`NCT00390598` - PEG Solution (Laxabon®) 4L Versus Senna Glycoside (Pursennid® Ex-Lax) 36mg and PEG Solution (Laxabon®) 2L for Large Bowel Cleansing Prior to Colonoscopy	Phase 2/Phase 3
Completed	`NCT00209573` - A Study of AQUAVAN® Injection Versus Midazolam HCl for Sedation in Patients Undergoing Elective Colonoscopy	Phase 3
Completed	`NCT00427089` - Comparison of 2L NRL994 With NaP Preparation in Colon Cleansing Prior to Colonoscopies for Colon Tumor Screening	Phase 3
Completed	`NCT05823350` - The Effect of Abdominal Massage on Pain and Distention After Colonoscopy	N/A