Can an alert in primary care electronic medical records increase participation in a population-based screening programme for colorectal cancer? COLO-ALERT, a randomised clinical trial
Can an alert in primary care electronic medical records increase participation in a population-based screening programme for colorectal cancer? COLO-ALERT, a randomised clinical trial
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DOI：
10.1186/1471-2407-14-232
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发表时间：
2014-03-31
期刊：
影响因子：
3.8
通讯作者：
Toran-Monserrat, Pere
中科院分区：
文献类型：
--
作者：
Guiriguet-Capdevila, Carolina;Munoz-Ortiz, Laura;Toran-Monserrat, Pere
背景：结直肠癌是西班牙的一个重要的公共卫生问题。在过去的十年中，一些地区开展了筛查计划，但人口参与率仍低于建议的欧洲目标。电子病历提醒已被认为是提高参与度的低成本、高影响力策略。需要进一步了解它们对基于人群的筛查计划的影响。本研究的主要目的是评估电子提醒对于促进参与基于人群的结直肠癌筛查计划的有效性。次要目标是了解人们拒绝参加筛查计划的原因，并了解卫生专业人员对官方计划实施和新计算机化工具的意见。方法/设计：这是一项具有横断面第二阶段的平行随机试验。参与者：所有受邀参加公共结直肠癌筛查计划的受试者，包括年龄在 50-69 岁之间的男性和女性，分配给该研究的 11 个初级保健中心及其所有卫生专业人员。随机分组单位将是初级保健医生。该干预措施将包括在患者的电子病历中激活电子提醒，以在干预实施的全年同步医疗预约期间促进结直肠癌筛查。然后，将使用对照组和干预组患者的粪便潜血测试来比较筛查率。我们还将进行问卷调查，了解卫生专业人员的意见。主要结果是研究结束时的筛查状态。数据将采用意向治疗方法进行分析。讨论：我们预计，在电子病历中引入具体提醒，作为促进和鼓励医生和护士直接转诊进行结直肠癌筛查的工具，将意味着目标人群的参与度增加。这种新软件工具的推出将获得良好的接受度，并提高对卫生专业人员建议的遵守程度。
Background: Colorectal cancer is an important public health problem in Spain. Over the last decade, several regions have carried out screening programmes, but population participation rates remain below recommended European goals. Reminders on electronic medical records have been identified as a low-cost and high-reach strategy to increase participation. Further knowledge is needed about their effect in a population-based screening programme. The main aim of this study is to evaluate the effectiveness of an electronic reminder to promote the participation in a population-based colorectal cancer screening programme. Secondary aims are to learn population's reasons for refusing to take part in the screening programme and to find out the health professionals' opinion about the official programme implementation and on the new computerised tool.Methods/Design: This is a parallel randomised trial with a cross-sectional second stage. Participants: all the invited subjects to participate in the public colorectal cancer screening programme that includes men and women aged between 50-69, allocated to the eleven primary care centres of the study and all their health professionals. The randomisation unit will be the primary care physician. The intervention will consist of activating an electronic reminder, in the patient's electronic medical record, in order to promote colorectal cancer screening, during a synchronous medical appointment, throughout the year that the intervention takes place. A comparison of the screening rates will then take place, using the faecal occult blood test of the patients from the control and the intervention groups. We will also take a questionnaire to know the opinions of the health professionals. The main outcome is the screening status at the end of the study. Data will be analysed with an intention-to-treat approach.Discussion: We expect that the introduction of specific reminders in electronic medical records, as a tool to facilitate and encourage direct referral by physicians and nurse practitioners to perform colorectal cancer screening will mean an increase in participation of the target population. The introduction of this new software tool will have good acceptance and increase compliance with recommendations from health professionals.