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Published in: Journal of General Internal Medicine 10/2020

01-10-2020 | Original Research

Advanced Notification Calls Prior to Mailed Fecal Immunochemical Test in Previously Screened Patients: a Randomized Controlled Trial

Authors: Briton Lee, MD, Shreya Patel, MD, MPH, Carly Rachocki, MPH, Rachel Issaka, MD, MAS, Eric Vittinghoff, PhD, Jean A. Shapiro, PhD, Uri Ladabaum, MD, MS, Ma Somsouk, MD, MAS

Published in: Journal of General Internal Medicine | Issue 10/2020

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Abstract

Background

Phone calls as part of multimodal fecal immunochemical test (FIT) outreach are effective but resource-intensive. Previous studies of advanced notification calls before FIT mailing have not differentiated patients’ prior screening status.

Objective

To determine the effectiveness of a phone call preceding mailing of a FIT kit on test completion rate for patients who have completed a prior FIT.

Design

Randomized controlled trial nested within a larger study. All patients were assigned to receive organized mailed FIT outreach in the larger study.

Participants

Patients in a safety-net health setting ages 50–75 years old with a previously negative FIT.

Interventions

Patients were assigned to either receive an advanced notification phone call or no phone call preceding a mailed FIT kit. Both groups received an informational postcard prior to the mailed FIT.

Main Measures

The primary outcome was FIT completion rate at 1 year. The secondary outcomes were FIT completion rates at 60, 90, and 180 days, rates stratified by demographic subgroups, and rates according to outcome of the phone call.

Key Results

A total of 1645 patients were assigned to advanced notification calls and 1595 were assigned to no call preceding the FIT mailing. Although FIT completion rate was higher at day 60 (55.5% vs. 50.8%, p < 0.01), an advanced notification call did not significantly improve FIT completion at 1 year (70.9% vs. 69.9%, p = 0.52). Of the patients assigned to receive an advanced notification call, 90.5% were spoken with or left a voicemail; patients who were spoken with were more likely to complete a FIT at 1 year compared with patients who were only left a voicemail or could not be left a voicemail (79.9% vs. 69.2% vs. 49.6%, p < 0.01).

Conclusions

Advanced notification phone calls prior to FIT mailing did not improve rates at 1 year for patients with a previously negative FIT.
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Metadata
Title
Advanced Notification Calls Prior to Mailed Fecal Immunochemical Test in Previously Screened Patients: a Randomized Controlled Trial
Authors
Briton Lee, MD
Shreya Patel, MD, MPH
Carly Rachocki, MPH
Rachel Issaka, MD, MAS
Eric Vittinghoff, PhD
Jean A. Shapiro, PhD
Uri Ladabaum, MD, MS
Ma Somsouk, MD, MAS
Publication date
01-10-2020
Publisher
Springer International Publishing
Published in
Journal of General Internal Medicine / Issue 10/2020
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-020-06009-4

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