Cost-effectiveness of a mailed educational reminder to increase colorectal cancer screening

BMC Gastroenterology

Research Article

Theodore G Ganiats¹  Jeffrey K Lee²  Samuel B Ho²  Erik J Groessl³ 

[1] Department of Family and Preventive Medicine, University of California, San Diego;, 9500 Gilman Drive, 92093, La Jolla, California, USA;Department of Medicine, VA San Diego Healthcare System and University of California, San Diego, 3350 La Jolla Village Drive, 92161, San Diego, California, USA;Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, 92161, San Diego, California, USA;Department of Family and Preventive Medicine, University of California, San Diego;, 9500 Gilman Drive, 92093, La Jolla, California, USA;

关键词: Cost-effectiveness;    Reminder;    Colorectal Cancer;    Screening;    FOBT;   

DOI  :  10.1186/1471-230X-11-93

 received in 2010-10-11, accepted in 2011-08-25,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundColorectal cancer (CRC) screening rates are low in many areas and cost-effective interventions to promote CRC screening are needed. Recently in a randomized controlled trial, a mailed educational reminder increased CRC screening rates by 16.2% among U.S. Veterans. The aim of our study was to assess the costs and cost-effectiveness of a mailed educational reminder on fecal occult blood test (FOBT) adherence.MethodsIn a blinded, randomized, controlled trial, 769 patients were randomly assigned to the usual care group (FOBT alone, n = 382) or the intervention group (FOBT plus a mailed reminder, n = 387). Ten days after picking up the FOBT cards, a 1-page reminder with information related to CRC screening was mailed to the intervention group. Primary outcome was number of returned FOBT cards after 6 months. The costs and incremental cost-effectiveness ratio (ICER) of the intervention were assessed and calculated respectively. Sensitivity analyses were based on varying costs of labor and supplies.ResultsAt 6 months after card distribution, 64.6% patients in the intervention group returned FOBT cards compared with 48.4% in the control group (P < 0.001). The total cost of the intervention was $962 or $2.49 per patient, and the ICER was $15 per additional person screened for CRC. Sensitivity analysis based on a 10% cost variation was $13.50 to $16.50 per additional patient screened for CRC.ConclusionsA simple mailed educational reminder increases FOBT card return rate at a cost many health care systems can afford. Compared to other patient-directed interventions (telephone, letters from physicians, mailed reminders) for CRC screening, our intervention was more effective and cost-effective.

【 授权许可】

Unknown   
© Lee et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.