Optimizing Gastrointestinal Procedure Appointments

Not Applicable

Completed

• Conditions: Gastrointestinal Disease
• Interventions: Behavioral: An Enhanced Reminder

• Registration Number: NCT03879616
• Lead Sponsor: Kaiser Permanente

Brief Summary

This project will address the question:

Does an "enhanced" IVR-T protocol differ in effectiveness from the standard IVR-T protocol in reducing missed appointments and late cancellations for GI endoscopy? Hypothesis: The enhanced IVR-T protocol will be more effective.

Detailed Description

This study will be a randomized trial over a 6-month period (March 8 through September 7, 2019) in 3 GI endoscopy clinics (Franklin, Rock Creek, and Lone Tree). All members currently receive a text reminder 7 days prior to their procedure, which rolls over to a telephone reminder if the text cannot be delivered or the member's phone is not text-enabled. Members will be randomized either to receive this standard IVR-T protocol (control) or to receive an enhanced reminder (intervention) protocol.

Randomization: Beginning in March 8, 2019, a randomization algorithm will be used in the Structured Query Language program that manages the IVR relational database to assign each visit for a procedure at all three sites to control or intervention. Since members with multiple procedures on different days during the study period could receive control or intervention for different visits, the statistical analysis will be limited to the first randomized appointment during the project period. Randomization will be stratified by clinic site.

Study Timeline

• Study Start: 2019-03-08
• Study First Submitted: 2019-03-08
• Study First Submitted QC: 2019-03-14
• Study First Posted: 2019-03-19
• Primary Completion: 2019-09-08
• Study Completion: 2021-12-31
• Status Verified: 2022-02
• Last Update Submitted: 2022-02-18
• Last Update Posted: 2022-02-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 15974

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
An Enhanced Reminder	An Enhanced Reminder	Members randomized to this arm of the study will receive an enhanced reminder protocol, which will include multiple reminders, multiple modalities, and motivational messages. The timing of reminders will depend on the wait time between the date the appointment is made and the date of the appointment. * An email reminder will be sent to all members who have provided their personal email information. * Members will receive up to two text messages that "roll over" to an IVR automated phone call if the text cannot be delivered. * Members scheduled for colonoscopy will also receive a single IVR-T reminder to begin their bowel prep the morning of the calendar day prior to the procedure.
Control	An Enhanced Reminder	Members randomized to this arm of the study will receive a single text message that "rolls over" to an IVR automated phone call if the text cannot be delivered. This message will be delivered 7 business days prior to the appointment. This replicates the current protocol for GI procedures. Of note, members who schedule appointments within 7 days of the procedure currently receive no reminders.

Primary Outcome Measures

Name	Time	Method
Rate of Cancellation and Rate of Missed Appointments	6 months	The primary outcome for the study will be "appointment loss," defined by GI leaders as the combined rate of prior day cancellations, same-day cancellations, and missed clinic appointments ("no shows"). The rationale for this outcome definition is that it is difficult to schedule new procedures within this time frame.

Secondary Outcome Measures

Name	Time	Method
The Boston Bowel Preparation Measure	6 months	A secondary outcome will be the assessment of the adequacy of the bowel preparation for colonoscopy only.

Trial Locations

Locations (1)

Kaiser Permanente; 🇺🇸 Aurora, Colorado, United States