A study from the Perelman School of Medicine at the University of Pennsylvania found that liver cancer screening rates among patients with cirrhosis nearly doubled when they were mailed a signed order from their specialist. This study, published in Hepatology Communications, did not find any significant difference in screening completion rates when a $20 incentive was added to the mailed orders.
Key points from the study include:
Increased Screening Rates: When patients with cirrhosis were mailed an order to get an abdominal ultrasound, about 55% completed their screening within six months of receiving the letter. This rate was significantly higher compared to the usual care group, where only 27% of patients got their ultrasound.
Importance of Screening: The mailed letters included information on why ultrasounds are important for patients with cirrhosis, particularly because they are at high risk for hepatocellular carcinoma, a major cause of cancer deaths worldwide.
Nudging Toward Positive Decisions: The study utilized the principle of “nudging,” a behavioral science technique meant to subtly and easily move people toward making positive decisions. Mailing orders and explanatory letters aimed to make the right decision (getting a screening ultrasound) the easiest for patients.
Effectiveness of Financial Incentives: The addition of a $20 incentive for opening the mail did not significantly increase the screening rates. The study suggests that larger incentives or conditional incentives might be more effective, but there is mixed data on the effectiveness of financial incentives for preventive health activities.
Communication Methods: The study highlights the advantage of mail over other methods of communication with patients, especially since most patients can receive mailings, even if they have differential access to internet or smartphones.
This study underscores the effectiveness of direct mail as a communication tool to increase liver cancer screening rates among high-risk patients and suggests that simple interventions can significantly impact public health outcomes.