Electronic messages may increase colorectal screening rates

Personalized electronic messages to patients overdue for screenings and mailings targeted to patients with expired orders for colonoscopies may increase colorectal cancer screening rates over the short term, according to two reports posted online that will be published in the April 11 print issue of Archives of Internal Medicine.

In one article, Thomas D. Sequist, MD, MPH, of Brigham and Women’s Hospital, Harvard Medical School, and Harvard Vanguard Medical Associates, Boston, MA, and colleagues conducted a randomized controlled trial of an electronic patient messaging system involving 1,103 patients aged 50 to 75 years at one group practice. All patients had an electronic personal health record that indicated they were overdue for colorectal cancer screening.

Half of the patients were randomly assigned to receive a single electronic message from their physician highlighting their overdue status, along with a link to a Web-based tool to assess their risk for colorectal cancer. The control group did not receive any electronic messages.

One month after the electronic messages were sent, screening rates were higher among patients who received them than those who did not (8.3% versus 0.2%). This difference, however, was no longer significant after 4 months (15.8% versus 13.1%). The lack of a long-term effect may be due to other screening promotion activities conducted throughout the health system studied, including annual paper mailings to adults overdue for screening, the authors note.

In the second report, Kenzie A. Cameron, PhD, MPH, and colleagues at Feinberg School of Medicine and Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, conducted a randomized controlled trial involving 628 patients aged 50 to 79 years who had expired orders for screening colonoscopies. Half of the participants were randomly assigned to receive a mailing containing a reminder letter from their primary care physician, a brochure, and a DVD about colorectal cancer and the screening process, along with a follow-up telephone call. The other half, the usual care control group, did not receive any of these materials until after the study period.

Three months after the mailing, screening rates were 9.9% (31 of 314) among patients in the intervention group and 3.2% (10 of 314) among patients in the control group. After 6 months, 18.2% of those in the intervention group were screened, compared with 12.1% in the control group.