Patient-directed messaging improves colorectal cancer screening rates

SAN DIEGO — A messaging program tailored specifically for individual patients helped improve colorectal cancer screening rates compared with usual care, according to research presented at Digestive Disease Week.

However, Akinbowale O. Oyalowo, MD, of the Perelman School of Medicine at the University of Pennsylvania, and colleagues found that a messaging program that uses a generic message might have the same impact.

“Traditionally, health communication interventions have relied on targeted messaging. This involves delivery of messages to subgroups within a population based on shared characteristics, such as demographics,” Oyalowo said in his presentation. “Tailored messaging, on the other hand, relies on assessments of a person’s expressed attitudes and beliefs in order to deliver messages that are directly relevant to that specific individual.”

In their previous work, researchers developed an assessment tool designed to identify motivating messages related to CRC screening based on unique psychological and behavioral characteristics. They wanted to determine if a tailored-messaging system using this assessment could improve colonoscopy screening rates.

Investigators identified patients aged between 50 and 75 years who were eligible for CRC screening or surveillance but were not up to date with their colonoscopy appointments. They randomly assigned patients to either usual care consisting of a mailed letter (n = 161), generic messaging (n = 162) or tailored messaging (n = 163). Patients in the generic and tailored messaging arms were contacted by phone and completed the assessment. However, the generic group just received a standard message to encourage them to schedule a colonoscopy, while the tailored group received an individualized message.

The primary outcome of the study was colonoscopy completion within 120 days.

Oyalowo and colleagues found that colonoscopy completion was higher for both the tailored (33.7%) and the generic (34.6%) groups compared with usual care (19.3%; P = .003 and P = .002, respectively). Both groups also had better scheduling rates than usual care (54.6% and 55.6% vs. 25.5%; P < .001 for both).

When comparing both intervention arms with each other, researchers found no significant difference between the two.

Oyalowo said their findings could be limited by the study design.

“The tailored message intervention was limited to those subjects who answered a telephone call from a study member and completed the assessment over the telephone,” he said. “A telephone call might not be the best to administer the assessment and future interventions may benefit from other modes of message delivery, such as web-based materials or text messaging.” – by Alex Young

Reference:

Oyalowo AO, et al. Abstract 841; Presented at: Digestive Disease Week; May 18-21, 2019; San Diego.

Disclosures: Oyalowo reports no relevant financial disclosures. Please see the meeting disclosure index for all other authors’ relevant financial disclosures.