Clinical trial NCT01984918: Predictors of Colonoscopy Non-attendance and the Efficacy of a SMS Reminder to Reduce Non-attendance Rate
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)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Ultilization of Out-patient Colonoscopy Service
Lead sponsor: Chinese University of Hong Kong
Sponsor class: OTHER
First posted: 2013-11-15
Enrollment: 2225
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief 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.

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%.

Eligibility criteria: 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

Primary outcomes:
measure: Non-attendance rate of colonoscopy
timeFrame: Within one year after recruitment
Secondary outcomes:
measure: Predictors of colonoscopy non-attendance
timeFrame: Within one year after recruitment
measure: Bowel preparation level
timeFrame: Within one year after recruitment
measure: Predictors of bowel preparation
timeFrame: Within one year after recruitment
Other outcomes:
Locations:
city: Hong Kong
country: Hong Kong
facility: Alice Ho Miu Ling Nethersole Hospital
Study officials:
affiliation: Alice Ho Miu Ling Nethersole Hospital
name: Aric Josun Hui, MD
role: PRINCIPAL_INVESTIGATOR
References: