The uptake and effect of a mailed multi-modal colon cancer screening intervention: A pilot controlled trial

Lewis, Carmen L.; Brenner, Alison T.; Griffith, Jennifer M.; Pignone, Michael

doi:10.1186/1748-5908-3-32

Cited by 39 publications

(52 citation statements)

References 20 publications

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“…5 New quality measures that assess how well physicians actually engage patients in the decision-making process, as called for in the Affordable Care Act, are urgently needed to help eliminate such counterproductive beliefs and practices.…”

Section: Discussionmentioning

confidence: 99%

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An Effort To Spread Decision Aids In Five California Primary Care Practices Yielded Low Distribution, Highlighting Hurdles

Lin¹,

Halley

Rendle

et al. 2013

Health Affairs

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Despite the proven efficacy of decision aids as interventions for increasing patient engagement and facilitating shared decision making, they are not used routinely in clinical care. Findings from a project designed to achieve such integration, conducted at five primary care practices in 2010-12, document low rates of distribution of decision aids to eligible patients due for colorectal cancer screening (9.3 percent) and experiencing back pain (10.7 percent). There were also no lasting increases in distribution rates in response to training sessions and other promotional activities for physicians and clinic staff. The results of focus groups, ethnographic field notes, and surveys suggest that major structural and cultural changes in health care practice and policy are necessary to achieve the levels of use of decision aids and shared decision making in routine practice envisioned in current policy. Among these changes are ongoing incentives for use, physician training, and a team-based practice model in which all care team members bear formal responsibility for the use of decision aids in routine primary care. I ncreasing patient engagement has been advocated as a top priority for improving health care quality.1 Providing patients with information about their clinical options and activating patients to participate in informed discussions regarding their care are the foundation of shared decision making and a potential mechanism for increasing patients' engagement in their care.These concepts are particularly relevant when preference-sensitive decisions are being made, such as the choice of method for colorectal cancer screening or of treatment for back pain. In preference-sensitive decisions, more than one available option exists, each of which carries different risks and benefits, and patients' treatment preferences can vary. 3Although many potential pathways may be taken to help facilitate preference-sensitive decisions, the use of decision aids has been a commonly proposed and studied intervention. Decision aids, which are specifically designed to provide patients with the information necessary to engage in shared decision making with their care providers, serve as an adjunct to clinical consultations. They come in a variety of formats, including video, print, and online.The use of decision aids has been shown to increase patients' knowledge of available treatment options and to help clarify patients' preferences. 4 For example, national clinical practice guidelines suggest that the decision to undergo colorectal cancer screening be a shared one between physicians and patients, because multiple efficacious screening methods are available. 2 Studies have shown that patients' preferences for specific methods of colorectal cancer screening vary, and the use of decision aids on this topic has been linked to increases in screening rates. 5 However, there is evidence that despite physi-

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Section: Discussionmentioning

confidence: 99%

“…2 Studies have shown that patients' preferences for specific methods of colorectal cancer screening vary, and the use of decision aids on this topic has been linked to increases in screening rates. 5 However, there is evidence that despite physi- …”

mentioning

confidence: 99%

An Effort To Spread Decision Aids In Five California Primary Care Practices Yielded Low Distribution, Highlighting Hurdles

Lin¹,

Halley

Rendle

et al. 2013

Health Affairs

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show abstract

“…Other studies have mailed DVDs, 8,9,17,18 and some have also encouraged group discussions regarding PSA screening. 11,12 However, our study is larger than these previous studies and was performed in a more generalizable population in two settings in the US.…”

Section: Discussionmentioning

confidence: 98%

A Randomized Controlled Effectiveness Trial for PSA Screening Decision Support Interventions in Two Primary Care Settings

et al. 2015

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“…To date, our study is the first study that estimates the costs and cost-effectiveness of a patient-directed intervention (mailed educational reminder) on CRC screening among U.S. Veterans at average risk of developing CRC. Prior studies on cost-effectiveness of patient-directed interventions for CRC screening have shown mixed results (Table 4), with costs ranging from $43 to $5842 per additional individual screened for CRC [17,18,20,27]. In one study, Lairson and colleagues randomized their patients who received FOBT and flexible sigmoidoscopy (FS) referrals to either two rounds of mailed reminders, two rounds of tailored mailed reminders, or two rounds of reminder telephone calls along with the tailored mailed reminder [18].…”

Section: Discussionmentioning

confidence: 99%

“…Given the highly constrained resources for health promotion, it is essential for decision makers to require information on the costs and cost-effectiveness of the interventions. Although there have been several studies on the economics of cervical cancer and mammography screening promotion [13,14], few studies have evaluated the cost-effectiveness of patient or providerdirected interventions for CRC screening in average risk patients, especially in the VA population [15][16][17][18][19][20]. The primary aim of this study is to assess the costs and costeffectiveness of our mailed educational reminder on adherence with FOBT-type screening among the U.S.…”

Section: Introductionmentioning

confidence: 99%

1035 Cost-Effectiveness of a Mailed Educational Reminder to Increase Colorectal Cancer Screening

Lee¹,

Groessl²,

Ho³

2010

Gastroenterology

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Background: Colorectal cancer (CRC) screening rates are low in many areas and cost-effective interventions to promote CRC screening are needed. Recently in a randomized controlled trial, a mailed educational reminder increased CRC screening rates by 16.2% among U.S. Veterans. The aim of our study was to assess the costs and cost-effectiveness of a mailed educational reminder on fecal occult blood test (FOBT) adherence.

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The uptake and effect of a mailed multi-modal colon cancer screening intervention: A pilot controlled trial

Cited by 39 publications

References 20 publications

An Effort To Spread Decision Aids In Five California Primary Care Practices Yielded Low Distribution, Highlighting Hurdles

An Effort To Spread Decision Aids In Five California Primary Care Practices Yielded Low Distribution, Highlighting Hurdles

A Randomized Controlled Effectiveness Trial for PSA Screening Decision Support Interventions in Two Primary Care Settings

1035 Cost-Effectiveness of a Mailed Educational Reminder to Increase Colorectal Cancer Screening

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