119 Mail-Order Stool Testing Improves Fecal Calprotectin Stool Testing Compliance in Patients With Inflammatory Bowel Disease

Background: Fecal Calprotectin stool testing is a valuable noninvasive tool for monitoring and evaluating patients with inflammatory bowel disease (IBD). Prior work demonstrated patient preference and satisfaction with mail-out stool kits compared to traditional lab-based testing. This study aimed to determine whether mail-order stool testing improves patient compliance compared to traditional lab collection. Methods: Data from a single tertiary care center were extracted using EPIC Slicer Dicer. Orders for Fecal Calprotectin collected via traditional laboratory testing in 2023 were compared to orders in 2024, when mail-out stool testing was routinely offered. Completed versus canceled/expired orders, demographics, and geographic distribution were analyzed. Chi-square testing was used to assess statistical significance. Results: In 2023, 2,620 lab-based orders were placed, with 1,455 (55.5%) completed. The mean patient age was 51.6 years, 52.8% were female, and 15.8% resided out of state. In 2024, 1,542 mail-out orders were placed, with 1,095 (71.0%) completed. The mean age was 52.0 years, 57.2% were female, and 29.3% resided out of state. Completion rates were significantly higher with mail-out testing (+16.4 percentage points, P < 0.001). Out-of-state participation was also significantly greater (+13.7 percentage points, P < 0.001). Conclusions: Mail-out Fecal Calprotectin testing significantly improves completion rates and expands geographic reach compared to traditional lab-based methods. Adoption of remote testing strategies may reduce barriers to care, support timely disease monitoring, and improve compliance for patients with IBD.