Primary care endorsement letter and a patient leaflet to improve participation in colorectal cancer screening: results of a factorial randomised trial
Primary care endorsement letter and a patient leaflet to improve participation in colorectal cancer screening: results of a factorial randomised trial
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DOI：
10.1038/bjc.2011.255
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发表时间：
2011-08-09
影响因子：
8.8
通讯作者：
Mant, D.
中科院分区：
文献类型：
--
作者：
Hewitson, P.;Ward, A. M.;Mant, D.
背景技术背景：该试验旨在调查是否全科医生（GP）的信鼓励参与和更明确的传单解释如何完成粪便潜血试验（FOBT）包括与英格兰肠癌筛查计划邀请materials.METHODS：一个随机对照2 × 2析因试验进行了英格兰南部。2009年10月，共有1288名登记的患者参加了试验，其中20名GP受邀接受筛查。参与者被随机分配到全科医生的认可信和/或增强的信息传单与他们的FOBT套件。的主要结果进行了验证与返回的测试试剂盒在20 weeks.RESULTS：无论是GP的认可信和增强程序传单，每个增加了参与类似的6%，GP的信5.8%（95%CI：4.1-7.8%）和传单6.0%（95%CI：4.3-8.1%）。在意向治疗分析的基础上，随机效应逻辑回归模型证实两种干预措施之间没有重要的相互作用，并估计GP信函的校正率比为1.11（P = 0.038），传单为1.12（P = 0.029）。在不存在相互作用的情况下，确认了收到GP信函和传单的累加效应（11.8%，95% CI：8.5-16%）。按协议分析表明，插入电子GP的签名背书信与增加参与（P = 0.039）。结论：包括从每个病人的GP和更明确的程序传单背书信可以增加参与英国肠癌筛查计划相似的10%，20%的相对改善目前的性能。英国癌症杂志（2011）105，475-480。doi：10.1038/bjc.2011.255 www.bjcancer.com（C）2011英国癌症研究
BACKGROUND: The trial aimed to investigate whether a general practitioner's (GP) letter encouraging participation and a more explicit leaflet explaining how to complete faecal occult blood test (FOBT) included with the England Bowel Cancer Screening Programme invitation materials would improve uptake.METHODS: A randomised controlled 2 x 2 factorial trial was conducted in the south of England. Overall, 1288 patients registered with 20 GPs invited for screening in October 2009 participated in the trial. Participants were randomised to either a GP's endorsement letter and/or an enhanced information leaflet with their FOBT kit. The primary outcome was verified with return of the test kit within 20 weeks.RESULTS: Both the GP's endorsement letter and the enhanced procedural leaflet, each increased participation by similar to 6% the GP's letter by 5.8% (95% CI: 4.1-7.8%) and the leaflet by 6.0% (95% CI: 4.3-8.1%). On the basis of the intention-to-treat analysis, the random effects logistic regression model confirmed that there was no important interaction between the two interventions, and estimated an adjusted rate ratio of 1.11 (P = 0.038) for the GP's letter and 1.12 (P = 0.029) for the leaflet. In the absence of an interaction, an additive effect for receiving both the GP's letter and leaflet (11.8%, 95% CI: 8.5-16%) was confirmed. The per-protocol analysis indicated that the insertion of an electronic GP's signature on the endorsement letter was associated with increased participation (P = 0.039).CONCLUSION: Including both an endorsement letter from each patient's GP and a more explicit procedural leaflet could increase participation in the English Bowel Cancer Screening Programme by similar to 10%, a relative improvement of 20% on current performance. British Journal of Cancer (2011) 105, 475-480. doi:10.1038/bjc.2011.255 www.bjcancer.com (C) 2011 Cancer Research UK