Online, Mail Reminders Improve Colon Cancer Screening Rates
Posted Dec 13 2010 4:00pm
But the advantages tend to fade over time and screening rates are still low, researchers find
By Robert Preidt
Monday, December 13, 2010
MONDAY, Dec. 13 (HealthDay News) -- Both electronic and mailed reminders help encourage some patients to get colorectal cancer screenings, two new studies show.
One study included 1,103 patients, aged 50 to 75, at a group practice who were overdue for colorectal cancer screening. Half of them received a single electronic message from their doctor, along with a link to a Web-based tool to assess their risk for colorectal cancer. The other patients acted as a control group and did not receive any electronic messages.
One month later, the screening rates were 8.3 percent for patients who received the electronic reminders and 0.2 percent in the control group. But the difference was no longer significant after four months -- 15.8 percent vs. 13.1 percent.
Among the 552 patients who received the electronic message, 54 percent viewed it and 9 percent used the Web-based assessment tool. About one-fifth of the patients who used the assessment tool were estimated to have a higher-than-average risk for colorectal cancer. Patients who used the risk tool were more likely to get screened.
"Patients have expressed interest in interacting with their medical record using electronic portals similar to the one used in our intervention," wrote Dr. Thomas D. Sequist, Brigham and Women's Hospital and Harvard Medical School, and colleagues, in a news release.
"Further research is needed to understand the most effective ways for patients to use interactive health information technology to improve their care and to reduce the morbidity and mortality of colorectal cancer," he said.
The second study included 628 patients, aged 50 to 79, who had an expired order for a screening colonoscopy. Half of the patients were mailed a reminder letter from their doctor, a brochure and a DVD about colorectal cancer and the screening process. They also received a follow-up telephone call.
The other patients were assigned to a control group that received usual care.
Three months after the mailings, 9.9 percent of patients in the intervention group and 3.2 percent of patients in the control group had undergone colorectal cancer screening. After six months, the rates were 18.2 percent and 12.1 percent.
"Because the screening rate remained low, additional research is needed to determine how to best promote screening in this patient group," concluded Kenzie A. Cameron and colleagues at Feinburg School of Medicine and Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, in a news release.
"At present, health systems could reasonably choose to begin screening promotion with low-cost interventions like simple mailings followed by more expensive, but potentially more effectivem, interventions such as one-on-one patient navigation or interventions aimed at eliminating structural barriers for patients who remain unscreened," they concluded.
Both studies appear online Dec. 13 and in the April 2011 print issue of the Archives of Internal Medicine.