Effect of Physician Notification Regarding Nonadherence to Colorectal Cancer Screening on Patient Participation in Fecal Immunochemical Test Cancer Screening

Abstract

Increasing participation in fecal screening tests is a major challenge in countries that have implemented colorectal cancer (CRC) screening programs.OBJECTIVE To determine whether providing general practitioners (GPs) a list of patients who are nonadherent to CRC screening enhances patient participation in fecal immunochemical testing (FIT). DESIGN, SETTING, AND PARTICIPANTSA 3-group, cluster-randomized study was conducted from July 14, 2015, to July 14, 2016, on the west coast of France, with GPs in 801 practices participating and involving adult patients (50-74 years) who were at average risk of CRC and not up-to-date with CRC screening. The final follow-up date was July 14, 2016.INTERVENTIONS General practitioners were randomly assigned to 1 of 3 groups: 496 received a list of patients who had not undergone CRC screening (patient-specific reminders group, 10 476 patients), 495 received a letter describing region-specific CRC screening adherence rates (generic reminders group, 10 606 patients), and 455 did not receive any reminders (usual care group, 10 147 patients). MAIN OUTCOMES AND MEASURESThe primary end point was patient participation in CRC screening 1 year after the intervention. RESULTS Among 1482 randomized GPs (mean age, 53.4 years; 576 women [38.9%]), 1446 participated; of the 33 044 patients of these GPs (mean age, 59.7 years; 17 949 women [54.3%]), follow-up at 1 year was available for 31 229 (94.5%). At 1 year, 24.8% (95% CI, 23.4%-26.2%) of patients in the specific reminders group, 21.7% (95% CI, 20.5%-22.8%) in the generic reminders group, and 20.6% (95% CI, 19.3%-21.8%) in the usual care group participated in the FIT screening. The between-group differences were 3.1% (95% CI, 1.3%-5.0%) for the patient-specific reminders group vs the generic reminders group, 4.2% (95% CI, 2.3%-6.2%) for the patient-specific reminders group vs the usual care group, and 1.1% (95% CI, −0.6% to 2.8%) for generic reminders group vs the usual care group. CONCLUSIONS AND RELEVANCEProviding French GPs caring for adults at average risk of CRC with a list of their patients who were not up-to-date with their CRC screening resulted in a small but significant increase in patient participation in FIT screening at 1 year compared with patients who received usual care. Providing GPs with generic reminders about regional rates of CRC screening did not increase screening rates compared with usual care.

Effectiveness of guideline dissemination and implementation strategies on health care professionals’ behaviour and patient outcomes in the cancer care context: a systematic review

“…The RCTs reviewed had moderate to high risk of bias; study quality was primarily limited by a lack of blinding and allocation concealment (see Table 2). All quasi-experimental studies were judged to have an overall serious Ayanian et al [29] Burack et al [31] Carney et al [32] Du Pen et al [35] Du Pen et al [36] Emery et al [37] Ferreira et al [38] Ganz et al [39] Gorin et al [40] Hillman et al [41] Kerfoot et al [43] Lane et al [45] Ling et al [46] Manfredi et al [47] McDonald et al [48] Myers et al [27] Myers et al [26] Ornstein et al [49] Rat et al [53] Roila et al [56] Sequist et al [57] risk of bias; study quality was primarily limited by inappropriate measurement of outcomes, missing data, and the presence of confounding variables (see Table 3).…”

Effect of an Automated Patient Dashboard Using Active Choice and Peer Comparison Performance Feedback to Physicians on Statin Prescribing

“…First, our findings add to the growing literature on using patient dashboards to change physician behavior. A trial by Rat et al 29 generated a list of patients due for colorectal cancer screening and found that sending the list to physicians led to a significant increase in screening. However, the patient list was sent by mail and may be less scalable than approaches that leverage technology.…”

MiR-216b suppresses colorectal cancer proliferation, migration, and invasion by targeting SRPK1

“…However, despite therapy, a subset of patients are accompanied by local recurrences and metastases from tumor sites. 4 , 5 Thus, it is essential to hunt for a new target to repress CRC development.…”