Efficacy of communication skills training on colorectal cancer screening by GPs: a cluster randomised controlled trial

Abstract

Colorectal cancer (CRC) mass screening has been implemented in France since 2008. Participation rates remain too low. The objective of this study was to test if the implementation of a training course focused on communication skills among general practitioners (GP) would increase the delivery of gaiac faecal occult blood test and CRC screening participation among the target population of each participating GP. A cluster randomised controlled trial was conducted with GP's practice as a cluster unit. GPs from practices in the control group were asked to continue their usual care. GPs of the intervention group received a 4-h educational training, built with previous qualitative data on CRC screening focusing on doctor-patient communication with a follow-up of 7 months for both groups. The primary outcome measure was the patients' participation rate in the target population for each GP. Seventeen GPs (16 practices) in intervention group and 28 GPs (19 practices) in control group participated. The patients' participation rate in the intervention group were 36.7% vs. 24.5% in the control group (P = 0.03). Doctor-patient communication should be developed and appear to be one of the possible targets of improvement patients adherence and participation rate in the target population for CRC mass screening.

Impact of provider-patient communication on cancer screening adherence: A systematic review

“…A total of 35 articles were considered suitable for inclusion in the review. All but six of the articles were from the United States–other represented countries included Canada (25, 26), Singapore (27), Israel (28), France (29) and Italy (30). Many articles focused on unique populations, including ethnic minorities, rural and urban residents, and veterans.…”

“…The communication skills trainings varied substantially in the complexity and content of the interventions. One intervention was relatively simple, consisting of instructing physicians to spend a few minutes discussing the importance of screening with patients (28), while others were more complex and included team workshops, video training and multiple feedback sessions (29, 39, 40). Another article with three findings included in the review relied primarily on training with standardized patients (16).…”

“…Both mammography interventions reported that significantly more women in the intervention group were screened than women in the control group (16, 28). Additionally, four of the five colorectal screening findings found that patients included in the intervention arm were more likely to both receive a provider recommendation and be screened than the control group or at baseline (29, 39–41). However, one colorectal cancer screening analysis, and the Pap analysis from the same article, found no difference in the control and intervention arm for patient screening rates (16).…”

A systematic review of the psychological impact of false-positive colorectal cancer screening: What is the role of the general practitioner?

“…Moreover, physician counselling is not only associated with greater screening intention but also in completion of screening and adherence to follow‐up screening (Aubin‐Auger et al., ; Fenton, Jerant, von Friederichs‐Fitzwater, Tancredi, & Franks, ). Given the possibility that distress might affect adherence to follow‐up screening after a false‐positive CRC screening result, we believe that this issue should also be explored with patients.…”

“…In the setting of increased screening implementation, general practitioners (GPs) may play a key role when informing patients about the benefits and risks. However, the involvement of the GPs in CRC screening varies considerably across countries (Aubin‐Auger et al., ). In some countries, the target population is invited directly through GPs, whereas in other countries, they are invited by mail from a screening organisation that provide a sampling kit directly, leaving GPs to play a minor role.…”