Text Message Reminder Improves Colonoscopy Adherence

A text message reminder one week prior to a scheduled colonoscopy significantly decreased the number of patients who did not show up to their appointment, according to a study published in Health Education & Behavior.

Researchers conducted a prospective study of patients aged 18 to 75 years who were scheduled for an outpatient colonoscopy at an urban endoscopy center in April 2018.

Patients received an interventional bidirectional, automated text messages prior to the procedure (n=21) or usual care (n=50; defined as standard paper instructions and phone call reminder). They assessed colonoscopy appointment adherence, bowel preparation quality, and colonoscopy completion.

Improved adherence with text message prompts

Those in the intervention cohort had higher colonoscopy appointment adherence (90%) than the usual care group (62%; P=0.049). There were no significant differences in preparation quality or procedure completeness. A post-study survey indicated that patients who received the intervention were satisfied and perceived the program as useful.

“We think text messaging is successful because it is patient-centered. It is already widely used by our patient population, does not require much effort by the patient to participate, and patients can read or respond whenever they choose,” said senior author Shivan Mehta, MD, MBA, assistant professor of medicine and the associate chief innovation officer at Penn Medicine. “Texting is also especially appealing to health systems because it is scalable and efficient; it’s a tactic many others have employed in order to communicate with patients.”

Examples of the automated messages patients were sent included a congratulatory text and colonoscopy date reminder upon enrollment; a reminder with the office’s address linked and a prompt for any questions about the procedure one-week before the appointment; a reminder to pick up prep materials (such as sports drinks and laxatives) from the pharmacy five days prior; and messages to prompt each step of the prep sequence the night before the appointment.

If patients responded with questions to any of the text prompts, the queries were escalated to gastroenterology staff, who answered within 24 hours. Three-quarters of patients responded to the prompts, according to the authors.

Colorectal cancer is the second deadliest cancer in the United States, and up to one in three patients are not up-to-date with their screening.