Dataset Information

GP Endorsement of Bowel Screening

ABSTRACT: Background and study aims: Colorectal (bowel) cancer is the second leading cause of cancer death in the UK, and costs the National Health Service (NHS) more than £300 million a year in treatment costs. Patient survival could be increased and, costs very much reduced, if patients with bowel cancer received their diagnosis earlier, allowing treatment to begin earlier. The NHS Bowel Cancer Screening Programme (NHSBCSP) was introduced in England in 2006, and aims to screen men and women aged between 60 to 74 years of age for bowel cancer every two years using the faecal occult blood test (FOBt). Initial studies have shown that bowel screening is effective, but the number of patients who participate in screening have been quite low, with only around half of all the people who are invited to participate returning their FOBt kit. The success of the NHSBCSP relies on a high number of patients participating, and the development of new ways to improve the number participating after they are invited to participate. The main aim of the study is to assess how effective a GP reminder and additional FOBt kit are on increasing the number who participate in bowel cancer screening, when they have not participated following a previous invitation. Who can participate? All adults eligible for bowel screening (aged between 60 to 74 years old). These were patients at a participating general practice in the West Midlands, where the screening rate is less than 50%. These patients had been invited to participate in bowel screening but had not returned their FOBt within 13 weeks of initial invitation by the Midlands and North West Bowel Cancer Screening Hub. What does the study involve? We will randomly allocate the participants to one of two groups: 1. GP reminder to participate in bowel screening and additional FOBt kit, OR 2. No additional contact We compared how may people participated in bowel screening after 13 weeks. This was measured by the number of FOBt kits that were returned to the bowel screening hub by patients in each group. This allowed us to assess if the GP reminder to participate in bowel screening and additional FOBt kit was successful in increasing the participation in bowel screening. A small interview was carried out with some patients who received the GP reminder who returned a FOBt kit.

DISEASE(S): Bowel Cancer

PROVIDER: 2425164 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Interventions: The study aims to improve rates of bowel cancer screening by assessing uptake of Fecal Occult Blood test via General Practice compared to direct mail through the National Bowel Cancer Screening Program. Subjects will be invited to take part in the study during a routine visit to the GP. The GP or practice nurse will explain the study and provide the subject information and consent forms along with a FOBt kit to take home. How to use the kit will also be explained by the GP or practice nurse along with what the results mean. The FOBt kit will be completed by the participant at home and mailed to the pathology lab. Results from the kit will be sent by the pathology lab to the participant and the GP and the University NSW assistant researcher collating the data. If the kit is negative the GP will invite the participant back for another test kit in 2 years time as per medical guidelines. If the test kit is positive the participant will be invited back to see the GP and discuss the next step. Subjects will be requested to consent to take part in the study for a total period of 6 months. Results of the FOBt will be recorded along with any further investigations which may be required. All data will be non-identifiable. Subjects have the right to withdraw at any time. Primary outcome(s): On initial presentation to their GP, subjects who have consented to take part in the study will be given information (written & verbal) on bowel cancer screening and offered an FOBt kit. The number of FOBt kits offered compared to returned kits (results data recorded by the pathology company) will be compared to the same in the National Bowel Cancer Screening Program.[The primary time point (baseline) will be the day of signing the consent form and being given bowel cancer screening education and an FOBt kit. Once the kits have been dispensed participants are given a time period within which to return them (3 months) and for results to be recorded by the pathology company. The primary time point is baseline where number of participants are recorded along with number of kits distributed. ] Study Design: Purpose: Prevention; Allocation: Non-randomised trial; Masking: Open (masking not used);Assignment: Single group;Type of endpoint: Efficacy

Project description:Interventions: Name of intervention: gender specific mail-administered screening invitation strategies. All participants will receive an offer to participate in a free FOBT which will be delivered by mail. Intervention arms will differ from control according to the information included in the materials accompanying the screening offer. All study participants will receive a standard screening reminder irrespective of their intervention group. Intervention materials will target specific psychosocial variables previously identified as being related to male participation in FOBT screening. The intervention period is 14 weeks. All participants will receive a screening offer according to the following timeline. Baseline: Advance notification letter sent Week two: Invitation package sent Week eight: Reminder letters sent to those who have not completed an FOBT Week 14: Data collection ceases. Arm 1: Control The control arm will receive a standard offer to participate in FOBT screening designed to mimic the strategy utilised by the Australian national bowel cancer screening program (NBCSP). The standard offer includes an advance notification letter and a screening invitation package. The advance notification letter is sent two weeks prior to the screening invitation package and is designed to alert participants that an invitation to screen for CRC with an FOBT will soon follow. The standard advance notification letter introduces basic information about colorectal cancer and the health benefits of screening. The screening invitation package includes a) a screening invitation letter b) an immunochemical FOBT with associated instructions c) an information booklet that describes colorectal cancer and screening and d) a particip Primary outcome(s): Rate of FOBT participation per trial arm as assessed by number of FOBT screening tests returned.[At 14 weeks from baseline, 12 weeks after receiving the FOBT.] Study Design: Purpose: Prevention; Allocation: Randomised controlled trial; Masking: Blinded (masking used);Assignment: Factorial;Type of endpoint: Efficacy

Project description:Background and study aims Colorectal cancer (CRC, also known as bowel cancer) is the fourth most common cancer and the second leading cause of cancer related deaths in England. Screening the at risk population for CRC by way of biennial faecal occult blood testing (FOBt) reduces CRC deaths by detecting CRC early, at a time when it is easier to treat. In England, the National Health Service (NHS) runs an organised population-based CRC screening programme (Bowel Cancer Screening Programme, BCSP), which offers biennial screening via guaiac-based faecal occult blood testing (gFOBt) to any men and women aged 60-74. With 54% overall uptake, CRC screening has the lowest uptake rate amongst all of the organised National Cancer Screening Programmes (Breast and Cervical Cancer Screening) in England. As such, there is an important need for interventions to promote uptake of FOBt in the capital to reduce inequalities in uptake. Increasing evidence demonstrates that General Practitioner (GP) endorsement promotes CRC screening uptake and there is a growing interest in the use text-message reminders to increase participation in cancer screening. The present study aims to investigate the effectiveness of a primary care based text-message reminder to promote CRC screening uptake in London. Who can participate? Adults aged between 60 to 75 who are eligible for bowel cancer screening. What does the study involve? Participants are randomly allocated to one of two groups. Participants are sent an invitation letter with screening information booklet by their local Hub. They then receive the gFOBt kit and instructions 8-10 days letter. They are asked to collect samples of three separate bowel motions and send the completed kit back to the hub. A letter is sent after four weeks of non-response. Those allocated to the first group receive a text message reminder to send their kit back. Those in the second group receive the standard screening materials. Uptake in both groups will be measured at 18 weeks and compared for statistically significant differences.

Project description:Interventions: Brief intervention name: Point-of-care clinical prompt (Prompt) Materials and Procedures: A point-of-care clinical prompt stating Encourage Participation in National Bowel Cancer Screening Program” will be attached to the electronic files of eligible patients (average risk patients turning 50, 60 and 70 years of age) within a general practice. These patients represent a sample of the population who will receive a National Bowel Cancer Screening Program (NBCSP) kit during the 12-month trial period. The prompt will remind General Practitioners (GPs) to talk to their patients about using the free kit when it arrives in the mail on or around the time of their birthday. National Bowel Cancer Screening Program (NBCSP) patient information brochures and posters will be available for general practitioner (GP) use as hard and/or electronic copies. Each GP in the trial will also recieve a sample NBCSP kit to show to patients during the consultation. Mode of delivery: The prompt will be set up by general practice administration staff within the electronic files of eligible patients. The prompt will be delivered to GPs as an electronic pop-up reminder at the start of a consultation. When an eligible patient arrives for their consultation at a practice, the prompt will ‘pop-up’ over the patient’s electronic file. The GP will then decide whether to discuss screening at that point in time or whether to ‘close’ the prompt. If the prompt is closed, it will remain as an outstanding action each time the patient attends the practice until such time as the GP marks the task as ‘performed’ by checking the relevent box. Additional resouces including patient information brochures and a sample/demonstration kit, will be made available by the GP during the consultation. Frequency and duration: The intervention will be trialled over 12 months. It is estimated that a total of 1750 patients will be eligible to have the prompt associated with their electronic file within the five intervention sites. This is the maximum number of times the prompt will be acted on by GPs. Location: The intervention will take place in five Tasmanian general practices located within Outer Regional and Remote Tasmania (Remoteness Areas 3 and 4). Adherence: GP adherence to using the prompt will be determined by the number of prompts that were marked as ‘performed’ compared to the number of prompts that were not.

Project description:Interventions: There are two intervention arms: Intervention arm 1 is an ‘SMS-only’ sent from general practice to patients, Intervention arm 2 is an ‘SMS-bundle’ - an SMS with additional video material sent from general practice to patients. The study is a cluster randomised controlled trial with the cluster unit being individual general practices. The intervention will be sent from general practices using an SMS service ‘GoShare’ depending on the cluster that the general practice has been randomised into. The SMS-only/SMS-bundle will be sent to eligible patients two weeks prior to when their National Bowel Cancer Screening Program (NBCSP) kit is due to arrive. The participants will only be sent one SMS-only or SMS-bundle. 1. The SMS-only is sent from a patient s general practice is to prompt patients to do the NBCSP kit. The SMS contains a greeting and the patient s first name, general practice name and telephone number, a GP endorsement of the NBCSP and the option to ‘opt-out’ of receiving future SMS. The wording in the SMS is: ‘Hi [insert patient first name]. Your free bowel cancer screening kit will arrive in the post soon. [insert general practice name] strongly encourages you to do this test. Call us on [insert general practice telephone number] if you have any questions. Reply STOP to opt out’. 2. The SMS-bundle is the SMS as described above, but with an web link to a GP message with the general practice logo and endorsing the NBCSP, a video of relatable people talking about why it is important to do the kit (approx 30 seconds long), an instructional video on how to do the kit (approx 45 seconds long), and a link to more information about the NBCSP. The wording is: ‘Hi [insert patient first name]. Your free bowel cancer screening kit will arrive in the Primary outcome: The primary outcome will be the difference in the proportion of patients who have a faecal occult blood test (FOBT) result recorded by the National Cancer Screening Register between the control arms and both interventions. This will be analysed by sex, age and location.[ The time point will be 6 months after the intervention phase is completed (SMS has been sent to patients). ] Study Design: Purpose: Prevention; Allocation: Randomised controlled trial; Masking: Blinded (masking used);Assignment: Parallel;Type of endpoint: Efficacy

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GP Endorsement of Bowel Screening

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