Comparative effectiveness of mailed reminders with and without fecal immunochemical tests for Medicaid beneficiaries at a large county health department: A randomized controlled trial

Cancer
Alison Tytell BrennerStephanie B Wheeler

Abstract

Colorectal cancer (CRC) screening is effective but underused. Screening rates are lower among Medicaid beneficiaries versus other insured populations. No studies have examined mailed fecal immunochemical testing (FIT)-based outreach programs for Medicaid beneficiaries. In a patient-level randomized controlled trial, a mailed CRC screening reminder plus FIT, sent from an urban health department to Medicaid beneficiaries, was compared with the same reminder without FIT. The reminder group could request FIT. Completed FIT kits were processed by the health department laboratory. Respondents were notified of normal results by mail. Abnormal results were given via phone by a patient navigator who provided counselling and assistance with follow-up care. The primary outcome was FIT return. In all, 2144 beneficiaries at average CRC risk were identified, and there was no evidence of screening with Medicaid claims data. To the reminder+FIT group, 1071 were randomized, and 1073 were randomized to the reminder group; 307 (28.7%) in the reminder+FIT group and 347 (32.3%) in the reminder group were unreachable or ineligible (previous screening). The FIT return rate was significantly higher in the reminder+FIT group than the reminder group (21...Continue Reading

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Citations

Jan 24, 2020·Clinical and Translational Gastroenterology·Omar BakrFolasade P May
Sep 19, 2019·The New England Journal of Medicine·Leora I HorwitzSimon A Jones
Mar 29, 2020·Journal of Community Health·Beverly B GreenGloria D Coronado
Sep 22, 2020·Therapeutic Advances in Gastroenterology·Rachel B IssakaJohn M Inadomi
Jan 13, 2021·Implementation Science Communications·Jennifer CouryGloria D Coronado
Oct 9, 2021·Implementation Science Communications·Teri L MaloUNKNOWN Scaling Colorectal Cancer Screening Through Outreach, Referral, and Engagement (SCORE) Study Protocol Consortium
Aug 3, 2020·Journal of the American Association of Nurse Practitioners·Linda Morrow, Beverly Greenwald
Dec 28, 2021·Population Health Management·Jordan J KarlitzDavid Lieberman

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