Encouraging participation in colorectal cancer screening for people with schizophrenia: A randomized controlled trial
Encouraging participation in colorectal cancer screening for people with schizophrenia: A randomized controlled trial
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DOI：
10.1111/acps.13348
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发表时间：
2021-08-02
影响因子：
6.7
通讯作者：
Inagaki, Masatoshi
中科院分区：
文献类型：
--
作者：
Fujiwara, Masaki;Yamada, Yuto;Inagaki, Masatoshi
目的 我们研究了病例管理方法在提高精神分裂症患者结直肠癌筛查参与度方面的有效性。方法 这是一项随机、平行组试验。我们从日本两家精神病医院招募了 40 岁或以上的精神分裂症门诊患者。参与者被随机分配（1:1）接受常规治疗或病例管理干预加基于网络的系统常规治疗。主治临床医生和参与者均未获知分配情况。病例管理包括使用粪便潜血测试进行结直肠癌筛查的教育和患者导航。像往常一样，待遇包括直接邮寄政府建议。主要终点是使用市政记录评估结直肠癌筛查的参与情况。我们还评估了参与其他癌症筛查（肺癌、胃癌、乳腺癌和宫颈癌）的次要终点。结果 2019年6月3日至9月9日期间，172名符合条件的参与者被随机分配到病例管理加常规治疗组（n = 86）或常规治疗组（n = 86）。一名参与者不符合资格，另一名参与者撤回同意；两者均被排除在分析之外。病例管理加照常治疗组中接受结直肠癌筛查的参与者比例显着高于照常治疗组（85 名参与者中的 40 名 [47.1%] 对比 85 名参与者中的 10 名 [11.8%]，p < 0.0001）。肺癌筛查比例也有所增加。没有发生与研究干预相关的严重不良事件。结论鼓励参加结直肠癌筛查的病例管理干预对精神分裂症患者有效。
Objective We examined the efficacy of a case management approach to improve participation in colorectal cancer screening among people with schizophrenia. Methods This was a randomized, parallel group trial. We recruited outpatients with schizophrenia aged 40 years or over from two psychiatric hospitals in Japan. Participants were randomly assigned (1:1) to treatment as usual or case management intervention plus treatment as usual using a web-based system. Attending clinicians and participants were unmasked to the allocation. Case management included education and patient navigation for colorectal cancer screening using a fecal occult blood test. Treatment as usual included direct mail government recommendations. The primary endpoint was participation in colorectal cancer screening assessed using municipal records. We also assessed the secondary endpoint of participation in other cancer screenings (lung, gastric, breast, and cervical). Results Between 3 June and 9 September 2019, 172 eligible participants were randomly assigned to the case management plus treatment as usual group (n = 86) or treatment as usual group (n = 86). One participant was ineligible and another withdrew consent; both were excluded from analysis. A significantly higher proportion of participants received colorectal cancer screening in the case management plus treatment as usual group than in the treatment as usual group (40 [47.1%] of 85 participants vs. 10 [11.8%] of 85 participants, p < 0.0001). The proportion of lung cancer screening also increased. No serious adverse events associated with the study intervention occurred. Conclusion The case management intervention to encourage participation in colorectal cancer screening was effective for patients with schizophrenia.