Appointments timed in proximity to annual milestones and compliance with screening: randomised controlled trial

doi:10.1136/bmj.a2794

Published 17 December 2008, doi:10.1136/bmj.a2794
Cite this as: BMJ 2008;337:a2794

Research

Christmas 2008: Seasonal Fayre

Appointments timed in proximity to annual milestones and compliance with screening: randomised controlled trial

Geir Hoff, professor of medicine and head of hospital research¹^,2^,3, Michael Bretthauer, gastrointestinal endoscopist and editorial fellow¹^,4^,5

¹ Cancer Registry of Norway, Oslo, Norway, ² Department of Medicine, Telemark Hospital, Norway, ³ University of Oslo, ⁴ Department of Gastroenterology, Rikshospitalet University Hospital, Oslo, ⁵ New England Journal of Medicine, Boston, USA

Correspondence to: G Hoff, Cancer Registry of Norway, Majorstuen, 0304 Oslo, Norway hofg{at}online.no

Objective To investigate whether appointments for screeningtimed in proximity to annual milestones (birthdays, Christmasand New Year) may be used as a strategy to improve attendancefor screening for colorectal cancer.

Design Randomised controlled trial.

Setting City of Oslo (urban) and Telemark county (urban andrural), Norway.

Participants 12 960 screened adults (64.7% of those invited).

Main outcome measure Attendance rates for each week and monthof assigned appointment.

Results Attendance rates were significantly higher in Decemberthan the rest of the year (72.3% v 64.6%, P<0.001) in adultswho received an invitation in the week of their birthday orwere assigned to screening in the first or second week aftertheir birthday (67.9% v 64.5%, P=0.007). This effect was mostpronounced in the urban population of Oslo. In a multivariablelogistic regression model, attendance improved in those whoreceived an invitation in the week of their birthday or wereassigned to screening in the first or second week after theirbirthday (odds ratio 1.15, 95% confidence interval 1.03 to 1.28)and those who were assigned to screening in December (odds ratio1.45, 1.16 to 1.82).

Conclusion Attendance rates for screening for colorectal cancerwere higher in December and around attendees’ birthdays,the latter particularly in an urban population. Compliance withscreening programmes may therefore be improved by timing invitationsin proximity to annual milestones.

Trial registration Clinical Trials NCT00119912 [ClinicalTrials.gov] .

Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Del.icio.us Del.icio.us Add to Digg Digg Add to Reddit Reddit Add to StumbleUpon StumbleUpon Add to Technorati Technorati What's this?