ACG: Spurring Colonoscopy Patients to Show Up

PHILADELPHIA, Oct. 16 -- Colonoscopy patients can be stimulated to show up for their appointments by an Internet-based educational program, investigators reported here.

Almost 90% of patients who viewed the program subsequently kept their scheduled colonoscopy appointment, compared with fewer than 70% of those who skipped the program, Tojo Thomas, M.D., of the University of Chicago, said at the American College of Gastroenterology meeting here.

Yet fewer than 15% of patients given the chance to view the program actually did so, possibly reflecting the older, inner-city population involved in the study.

"We plan to continue evaluating the program because it's obvious that patients who watch it are more likely to keep their colonoscopy appointments," said Dr. Thomas. "In the process, we hope to learn how we can increase the number of patients who watch it."

Missed appointments are an ongoing problem for colonoscopists and their staffs. The resulting time voids play havoc with clinic scheduling, said Dr. Thomas.

Techniques such as pre-procedure visits and telephone reminders have demonstrated potential for improving patient adherence to colonoscopy appointments.

Dr. Thomas and colleagues evaluated an online program developed by EMMI Solutions of Chicago. The program allows patients to learn about colonoscopy and preparation requirements prior to the procedure.

The study involved 333 consecutive English-speaking patients referred for colonoscopy. Each patient was assigned an EMMI number and instructions for accessing the Website and program prior to their colonoscopy procedures. Computer workstations also were made available for patient use.

The patients' mean age was 60, and two thirds were female. Only 45 patients (13.5%) viewed the instructional program prior to their scheduled colonoscopy procedures. Patients who watched the program were younger (57 versus 61, P=0.04), but otherwise did not differ from the patients who did not access the program. Dr. Thomas reported that 87% of male patients and 86% of female patients did not access the online program.

Subsequently, 40 of 45 (89%) patients who viewed the program showed up at the appointed time for their colonoscopy compared with 68% (196 of 288) patients who did not take time to watch the program (P=0.005). Quality of preparation and cecal intubation rates were not influenced by patient age, sex, or EMMI status.

"Internet-based pre-procedural programs such as this one appear to have potential to improve attendance at colonoscopy, but additional studies are needed to fully assess the impact on patient attendance and the quality of procedures," said Dr. Thomas.