A pilot study found that offering a convenient rideshare to get home after a colonoscopy procedure encourages people to attend colon cancer screening appointments they might otherwise have missed, according to findings presented at Digestive Disease Week.

“Colon cancer is one of the most preventable cancers, and one in three people who are due for screening have not completed it,” Rachel Issaka, MD, of the Fred Hutchinson Cancer Center said in a news release. “Improving screening and follow-up of noninvasive tests will help us find cancer earlier, when it’s easier to treat. Our study shows that there are practical solutions to these challenges, and they are necessary for those who experience the most disparities.”

At-home fecal tests are a recommended option for colorectal cancer screening, but if results are abnormal, a more invasive follow-up procedure such as a colonoscopy should be done. Health care facilities usually require patients to have a chaperone to take them home after being sedated for such a procedure—and in many cases, taxis or rideshares such as Lyft or Uber don’t qualify. But some people do not have family members or friends who can provide transportation, which can delay screening or follow-up.

Issaka and colleagues conducted a pilot study to assess whether providing a rideshare service for people who do not have an escort and transportation could help overcome this barrier. In particular, they hoped to reduce racial and socioeconomic disparities in colon cancer screening.

Major rideshare companies offer nonemergency medical transportation services that can be scheduled by a health care team and billed to insurance in a HIPAA-compliant manner, according to a Fred Hutch news report. But many patients and providers are not aware of them, and they are not part of standard procedures.

The study team recruited participants who sought colorectal cancer screening at the Harborview Medical Center in Seattle who did not have a chaperone or suitable transportation. About 70% were men, about 38% were white, 28% were Black, 25% were Latino, 13% were Asian and 4% were American Indian or Alaska Natives. Most participants usually used public transportation or walked to their appointments at the medical center.

Initially, the participants completed a survey about their demographic information, general health and transportation difficulties. As part of the study, the discharging nurse scheduled a Lyft Concierge ride to take people home after a colonoscopy. The participants then completed a phone interview describing their experiences a week or two after the procedure.

At the time of the presentation, 24 people had consented to take part in the study, and 21 rides were completed. All participants made it home safely. What’s more, they lauded the convenience and ease of the rideshare, citing short wait times, autonomy in medical care and not having to delay procedures.

“So, I really liked the independence that it offered to be able to just have a rideshare take me home and kind of, you know, handled my own business without bothering other people,” one participant said.

All but one of the participants reported they had a positive experience, and even this individual said they would use the service again or recommend it to a friend who needed a colonoscopy.

“Rideshare nonemergency medical transportation is a safe, reliable and acceptable transportation option for safety-net patients who received procedural sedation for colonoscopy completion,” the researchers concluded. “Rideshare nonemergency medical transportation could be a potentially scalable and cost-effective intervention to improve follow-up of abnormal noninvasive colorectal cancer screening tools.”

“We found that transportation costs were very modest, generally about $20 to $25 per ride, so we are also interested in exploring analyses that would encourage insurance companies to cover this service for patients who receive procedural sedation in the future,” Issaka said. She added that they team is looking to expanding the program, for example, to facilitate access to lung cancer screenings and other exams that involve sedation.

Click here to see the DDW poster.
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