Predictors of Colonoscopy Non-attendance and the Efficacy of a Short Message Service (SMS) Reminder to Reduce Non-attendance Rate

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT01984918
Recruitment Status : Recruiting
First Posted : November 15, 2013
Last Update Posted : November 7, 2017
Information provided by (Responsible Party):
Aric Josun Hui, Chinese University of Hong Kong

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.

Condition or disease Intervention/treatment Phase
Ultilization of Out-patient Colonoscopy Service Other: SMS Other: No SMS Not Applicable

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%.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 2706 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Health Services Research
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 Start Date : November 2013
Estimated Primary Completion Date : December 2018
Estimated Study Completion Date : December 2018

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Colonoscopy

Arm Intervention/treatment
Active Comparator: SMS
A SMS will be sent to remind subjects 7-10 days before his colonoscopy appointment
Other: SMS
A SMS reminder will be sent to patients 7 - 10 days before his colonoscopy appointment

Other: No SMS
No SMS reminder will be sent

No Intervention: Non-SMS
No SMS will be sent

Primary Outcome Measures :
  1. Non-attendance rate of colonoscopy [ Time Frame: 2 years ]

Secondary Outcome Measures :
  1. Predictors of colonoscopy non-attendance [ Time Frame: 2 years ]
  2. Bowel preparation level [ Time Frame: 2 years ]
  3. Predictors of bowel preparation [ Time Frame: 2 years ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

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

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01984918

Hong Kong
Alice Ho Miu Ling Nethersole Hospital Recruiting
Hong Kong, Hong Kong
Contact: Aric Hui    (852)90370001   
Principal Investigator: Aric Hui         
Sponsors and Collaborators
Chinese University of Hong Kong

Responsible Party: Aric Josun Hui, Dr., Chinese University of Hong Kong Identifier: NCT01984918     History of Changes
Other Study ID Numbers: NAC Study
First Posted: November 15, 2013    Key Record Dates
Last Update Posted: November 7, 2017
Last Verified: November 2017