Simple Interventions Boost Colonoscopy Effectiveness

Inexpensive interactions with colonoscopy patients can help to improve results in the procedure room as well as in the months and years following the screenings, say 2 new studies.

Noting that up to one-fourth of colonoscopy patients arrived for their procedures inadequately prepped, researchers at the UCLA-VA Center for Outcomes Research and Education in Los Angeles sought to create more effective pre-op instructions.

"Unlike every other screening test in medicine, the ability of the colonoscopy to reduce the risk for cancer is associated with the physical preparation by the patients themselves," says Brennan M.R. Spiegel, MD, MSHS, the center's director and author of a study appearing in the April 12 online edition of the American Journal of Gastroenterology.

The result was "Getting Ready for Your Colonoscopy," an attractively designed, user-friendly guide to the process (available for free download at the center's website). The booklet includes checklists, calendars and color pictures to assist patients in their preps. A test of its effectiveness against the center's standard directions found patients who received the booklet were more likely to arrive adequately prepped on the day of the screening.

Another study, published in the April issue of the journal Gastroenterology, showed that the low-cost intervention of a couple of letters and a telephone call were effective enough reminders to get patients overdue for screenings to schedule procedures.

The variability in colonoscopy patients' follow-up care can make it difficult for patients and providers to stay on top of the schedule. But researchers say that an electronic medical record system set up to issue reminders on overdue patients, and letters sent to the patient and his primary care physician, as well as a follow-up phone call, seemed to improve screening rates over those of patients who received fewer direct reminders.

"Although this study focused only on colonoscopy, it is expected that this approach would be widely applicable across different procedures and medical specialties," added Daniel A. Leffler, MD, MS, of Harvard Medical School, the study's lead author.

David Bernard