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

Ultilization of Out-patient Colonoscopy Service Clinical Trial

Official title:

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)

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01984918
• Other study ID #: NAC Study
• Status: Completed
• Phase: N/A
• Start date: November 2013
• Est. completion date: October 2019

Study information

• Verified date: April 2020
• Source: Chinese University of Hong Kong
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

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.

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%.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 2225
• Est. completion date: October 2019
• Est. primary completion date: October 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

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

Related Conditions & MeSH terms

• Ultilization of Out-patient Colonoscopy Service

Intervention

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
• Non-SMS reminder
No Stext message reminder via Short Message Service (SMS) will be sent

Locations

Country	Name	City	State
Hong Kong	Alice Ho Miu Ling Nethersole Hospital	Hong Kong

Sponsors (1)

Lead Sponsor	Collaborator
Chinese University of Hong Kong

Country where clinical trial is conducted

Hong Kong, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Non-attendance rate of colonoscopy	attendance of colonoscopy on the scheduled colonoscopy date	Within one year after recruitment
Secondary	Predictors of colonoscopy non-attendance	different risk factors which may predicts colonoscopy non-attendance	Within one year after recruitment
Secondary	Bowel preparation level	bowel preparation level of completed colonoscopy	Within one year after recruitment
Secondary	Predictors of bowel preparation	different risk factors which may predicts bowel preparation level	Within one year after recruitment