Forbes: Can texting patients who are scheduled for colonoscopy reduce ‘no-shows’?

“Colorectal cancer screening is a vital part of providing care in any medical practice.

The American Cancer Society (ACS) recommends that screening for colorectal cancer begin at age 45 in asymptomatic men and women, and every 10 years thereafter. Individuals at higher risk—those with a family history of colorectal cancer or polyps, history of ulcerative colitis or Crohns disease- should undergo screening earlier and more frequently. The May 2018 revision by the ACS—changing screening guidelines to age 45 as opposed to 50 in those at average risk—recommend continuing screening through age 75. They then recommend that those ages 76-85 engage in shared decision making with their healthcare provider about whether to continue screening based on risk factors, current state of health, and past screening history. According to the ACS, colorectal cancer is the third most common cause of cancer in both men and women in the U.S. They also estimate that there will be nearly 101,420 cases of colon cancer, along with 44,180 cases of rectal cancer in 2019. Diagnosing and detecting colorectal cancer is best accomplished by performing a colonoscopy. This is a procedure in which a specialized endoscope can examine the entire length of the colon. However, poor patient compliance with screening guideline schedules remains one of the main obstacles to providing up-to-date care faced by medical professionals. So how can the medical community best accomplish this task? Phone calls to patients, follow-up letters? One viable solution that has been explored is texting. Text messaging, in the setting of a medical practice, has the enhanced ability to connect with patients, and may in fact be more personalized than a simple phone call or letter. Text messaging can easily engage patients, initiating a seamless pathway of communication leading to a greater sense of obligation and responsibility to respond to a text. Researchers at the University of Pennsylvania explored this model of patient communication and found that harnessing the power of smartphones to text patients simple reminders and thereby engaging them in text-based conversations can help to boost rates of colonoscopies. They found that simple text conversations with patients one week before a scheduled colonoscopy significantly decreased the “no-show” rates, based on findings from their recent study. Engaging the patients by sending texts helped to encouraged patients to ask questions, which led to sharing of links and other important information with patients. These actions, the researchers believe, helped to increase the rate of colonoscopies to 90%, compared with the 62% compliance rate seen in a group who were not the recipient of the additional communication. The results of the study were published in the journal Health Education & Behavior. “Automated text messaging and new insights from behavioral science offer opportunities to effectively and efficiently engage with patients before important health prevention activities,” said the study’s senior author, Shivan Mehta, MD, MBA, an assistant professor of Medicine and the associate chief innovation officer at Penn Medicine. “It’s also important to keep in mind that these programs should be conducted in close partnership with clinical operations, and that we understand patient perspectives about these interventions.” In the U.S., despite the lethal nature of colorectal cancer, nearly one in three people are not up-to-date on screening. This statistic provided the rationale for Mehta and the study’s lead author, Nadim Mahmud, MD, MPH, a Hepatology fellow at the Hospital of the University of Pennsylvania, to explore how texting patients who are scheduled for upcoming colonoscopies affect screening rates.” Read more on Forbes.