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Related Concept Videos

Assessment of the Rectum and Anus01:25

Assessment of the Rectum and Anus

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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
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Automated Reminders Enhance Mailed Fecal Immunochemical Test Completion Among Veterans: a Randomized Controlled

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Automated phone or text reminders significantly boosted colorectal cancer screening completion rates in veterans using mailed fecal immunochemical testing (FIT). These reminders are a cost-effective strategy to improve participation in VHA screening programs.

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Area of Science:

  • Public Health
  • Preventive Medicine
  • Health Services Research

Background:

  • The Veterans Health Administration (VHA) aims to expand population-based colorectal cancer (CRC) screening for average-risk veterans using mailed fecal immunochemical testing (FIT).
  • Low response rates to mailed FIT kits present a significant challenge to the success of this initiative.
  • Evidence on the effectiveness of different reminder strategies in veteran populations is limited.

Purpose of the Study:

  • To evaluate the effectiveness of automated telephone call and text message reminders in improving mailed FIT response rates among veterans.
  • To compare the efficacy of phone versus text message reminders for CRC screening completion.

Main Methods:

  • A prospective, randomized quality improvement trial was conducted involving 2658 average-risk veterans (aged 45-75) at VA Puget Sound Health Care System.
  • Veterans who did not return a FIT kit within two weeks were randomized to receive either no reminder (control), an automated phone call reminder, or an automated text message reminder.
  • The primary outcome was FIT kit return at 90 days, with a secondary outcome of FIT return at 180 days.

Main Results:

  • Both automated phone and text message reminders significantly increased FIT return rates at 90 days compared to the control group (39% and 38% vs. 28%, respectively; p<0.001).
  • These higher return rates were sustained at 180 days, with reminder groups showing improved completion (42% and 40% vs. 32%; p<0.001).
  • Phone and text message reminders demonstrated comparable effectiveness in boosting screening completion.

Conclusions:

  • Automated telephone call and text message reminders are effective interventions for increasing colorectal cancer screening completion among average-risk veterans.
  • Either reminder method can be successfully implemented, offering flexibility for VHA facilities based on resource availability.
  • Implementing reminder systems is recommended for mailed FIT programs to enhance veteran participation in CRC screening.