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Controlled Clinical Trial
. 2012 Mar-Apr;73(2):93-8.

Two controlled trials to determine the effectiveness of a mailed intervention to increase colon cancer screening

Carmen L Lewis  1 , Alison Tytell Brenner, Jennifer M Griffith, Charity G Moore, Michael P Pignone
Affiliations
Controlled Clinical Trial

Two controlled trials to determine the effectiveness of a mailed intervention to increase colon cancer screening

Carmen L Lewis et al. N C Med J. 2012 Mar-Apr.

Abstract

Objective: Colorectal cancer (CRC) screening is underutilized. Effective and efficient interventions are needed to increase its utilization in primary care.

Methods: We used UNC Internal Medicine electronic medical records to perform 2 effectiveness trials. Eligible patients had no documentation of recent CRC screening and were aged 50-75 years. The mailed intervention contained a letter documenting the need for screening signed by the attending physician in wave A and the practice director in wave B, a postcard to request a decision aid about CRC screening options, and information about how to obtain screening.

Result: Three-hundred and forty patients of attending physicians in wave A, 944 patients of resident physicians in wave B, and 214 patients of attending physicians in wave B were included. The intervention increased screening compared with controls for attending physicians' patients in wave A (13.1% vs. 4.1%, 95% CI, 3.1%-14.9%) but not for resident physicians' patients in wave B (1.3% vs. 1.9%, 95% CI, -2.2% to 1.0%). A small increase in screening with the intervention was seen in attending physicians' patients in wave B (6.9% vs. 2.4%, 95% CI, -1.4% to 10.5%). Requests for decision aids were uncommon in both waves (12.5% wave A and 7.8% wave B).

Limitations: The group assignments were not individually randomized, and covariate information to explain the differences in effect was limited.

Conclusions: The intervention increased CRC screening in attending physicians' patients who received a letter from their physicians, but not resident physicians' patients who received a letter signed by the practice director.

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Conflict of interest statement

Potential conflicts of interest. All authors have no relevant conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Wave and Group Assignments
See this image and copyright information in PMC

References

    1. Denberg TD, Coombes JM, Byers TE, et al. Effect of a mailed brochure on appointment-keeping for screening colonoscopy: a randomized trial. Ann Intern Med. 2006;145(12):895–900. - PubMed
    1. Dietrich AJ, Tobin JN, Cassells A, et al. Telephone care management to improve cancer screening among low-income women: a randomized, controlled trial. Ann Intern Med. 2006;144(8):563–571. - PMC - PubMed
    1. Hulscher ME, Wensing M, Grol RP, van der Weijden T, van Weel C. Interventions to improve the delivery of preventive services in primary care. Am J Public Health. 1999;89(5):737–746. - PMC - PubMed
    1. Hulscher ME, Wensing M, van Der Weijden T, Grol R. Interventions to implement prevention in primary care. Cochrane Database Syst Rev. 2001;(1):CD000362. - PubMed
    1. Shankaran V, McKoy JM, Dandade N, et al. Costs and cost-effectiveness of a low-intensity patient-directed intervention to promote colorectal cancer screening. J Clin Oncol. 2007;25(33):5248–5253. - PubMed

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