Time for the Big Easy

March 20th, 2009 | Sources: Archives Int. Medicine, MedPageToday


thisgoeswhere?That Canadian study showing colonoscopy screening wasn’t as effective as first thought caused quite a dust up around the New Year, but consensus remains strong that the Big Easy is a life-saver and people need to get it done.

Yet only 60% of eligible patients report being up-to-date with the test and harried physicians often don’t have the time to discuss preventive services with their patients.

Which is why the results of a trial of a decidedly low-tech reminder system are so heartening.

timeforthebigeasyThomas Sequist and colleagues from the Brigham implemented a randomized trial of mailed reminders to patients and lo and behold, they actually improved colonoscopy utilization!

The scientists enrolled 21,860 patients between the ages 50-80 from 11 clinics during 2006-2007. All patients were overdue for the ‘scope.

Subjects either received nothing or a mailing that contained an educational pamphlet, a fecal occult blood testing pad, and instructions for scheduling a colonoscopy.

The scientists also sent electronic reminders to the patients’ primary care physicians.

Among patients who received the mailed reminders, 44% got it done. The number was 38% in the control group.

Reminders were increasingly effective as subjects got older, with the difference favoring the reminded group rising from 3.7% for ages 50 to 59 to 10.1% for ages 70 to 80.

The study is in the Archives of Internal Medicine.

if1worksdoes20workbetter?“Our findings underscore that informed patients can play an active role in completing effective preventive services,” the scientists concluded.

Interestingly, the electronic reminders to physicians didn’t boost colonoscopy rates, “in part because over one-third of patients had no visits with their primary care physician during the 15-month study period,” the scientists reported.


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