Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA.
Department of Internal Medicine, Washington University School of Medicine, St Louis, Missouri, USA.
Dig Dis. 2021;39(4):399-406. doi: 10.1159/000511767. Epub 2020 Sep 22.
Text message-based interventions reduce colonoscopy no-show rates and improve bowel preparation scores. In this non-randomized study, we assessed whether an interactive text messaging system could improve colonoscopy outcomes.
Colonoscopy pre-procedural instructions were programmed into a dedicated software platform created for this study. In the intervention arm, text messages were sent to veterans during a 4-week study period. Validated pre-procedural satisfaction questionnaires were completed by patients during standard protocol and intervention periods. Demographics and colonoscopy outcomes data were compared between the standard protocol and intervention arms, including procedure completion rate on scheduled date, Boston bowel preparation score (BPPS), adenoma detection rate, and satisfaction.
Of 241 patients, 128 were in the standard protocol arm and 113 in the intervention arm. Higher proportions of patients receiving text messages underwent colonoscopy on their scheduled date (69.9%) compared to the ones in the standard protocol (50.8%, p = 0.015). Patients with ≥3 interactions with the system had 80.6% likelihood of completing colonoscopy on the scheduled date compared to 56.9% with <3 interactions and 50.8% with standard protocol (p < 0.001). Frequency of interaction with the system was similar between older (>65 years) and younger patients (p = 1.0). Among older patients, colonoscopy was completed successfully in 84.2% when alert-based human interactions occurred compared to 65.6% in those without and 47.9% with standard protocol (p = 0.018). More than 90% indicated they would recommend the system to patients undergoing future colonoscopy.
An interactive text messaging system improves successful colonoscopy rates in a VA setting, with greatest impact in older patients.
基于文本信息的干预措施可降低结肠镜检查的爽约率并提高肠道准备评分。在这项非随机研究中，我们评估了交互式短信系统是否能改善结肠镜检查的结果。
将结肠镜检查前的说明编程到专为这项研究创建的专用软件平台中。在干预组中，在 4 周的研究期间向退伍军人发送短信。患者在标准方案和干预期间完成了经过验证的术前满意度问卷。比较了标准方案组和干预组之间的人口统计学和结肠镜检查结果数据，包括按计划日期完成的程序、波士顿肠道准备评分（BPPS）、腺瘤检出率和满意度。
在 241 名患者中，128 名在标准方案组，113 名在干预组。接受短信的患者中，在计划日期进行结肠镜检查的比例（69.9%）高于标准方案组（50.8%，p = 0.015）。与系统交互次数<3 次的患者相比，与系统交互次数≥3 次的患者有 80.6%的可能性按计划日期完成结肠镜检查，而交互次数<3 次的患者有 56.9%，标准方案组有 50.8%（p < 0.001）。系统交互频率在年龄较大（>65 岁）和年龄较小的患者之间相似（p = 1.0）。在年龄较大的患者中，当基于警报的人工交互发生时，84.2%的患者成功完成了结肠镜检查，而没有交互的患者为 65.6%，标准方案组为 47.9%（p = 0.018）。超过 90%的患者表示他们会向接受未来结肠镜检查的患者推荐该系统。
在 VA 环境中，交互式短信系统可提高结肠镜检查的成功率，对老年患者的影响最大。
