Training primary care physicians to offer their patients faecal occult blood testing and colonoscopy for colorectal cancer screening on an equal basis: a pilot intervention with before-after and parallel group surveys.

TitreTraining primary care physicians to offer their patients faecal occult blood testing and colonoscopy for colorectal cancer screening on an equal basis: a pilot intervention with before-after and parallel group surveys.
Publication TypeJournal Article
Year of Publication2016
AuthorsSelby, K, Cornuz, J, Gachoud, D, Bulliard, J-L, Nichita, C, Dorta, G, Ducros, C, Auer, R
JournalBMJ Open
Volume6
Issue5
Paginatione011086
Date Published2016
DOI10.1136/bmjopen-2016-011086
ISSN2044-6055
Mots-clésAdult, Attitude of Health Personnel, Attitudes, Colonoscopy, Colorectal Neoplasms/diagnosis, Early Detection of Cancer/methods, Female, Health Knowledge, Humans, Inservice Training/methods, Male, Mass Screening/methods, MEDICAL EDUCATION & TRAINING, Middle Aged, Occult Blood, Physician's Role, Physicians, Physicians'/statistics & numerical data, Pilot Projects, Practice, Practice Patterns, Primary Care, Primary Care/education
Abstract

OBJECTIVES: Primary care physicians (PCPs) should prescribe faecal immunochemical testing (FIT) or colonoscopy for colorectal cancer screening based on their patient's values and preferences. However, there are wide variations between PCPs in the screening method prescribed. The objective was to assess the impact of an educational intervention on PCPs' intent to offer FIT or colonoscopy on an equal basis.

DESIGN: Survey before and after training seminars, with a parallel comparison through a mailed survey to PCPs not attending the training seminars.

SETTING: All PCPs in the canton of Vaud, Switzerland.

PARTICIPANTS: Of 592 eligible PCPs, 133 (22%) attended a seminar and 106 (80%) filled both surveys. 109 (24%) PCPs who did not attend the seminars returned the mailed survey.

INTERVENTION: A 2 h-long interactive seminar targeting PCP knowledge, skills and attitudes regarding offering a choice of colorectal cancer (CRC) screening options.

OUTCOME MEASURES: The primary outcome was PCP intention of having their patients screened with FIT and colonoscopy in equal proportions (between 40% and 60% each). Secondary outcomes were the perceived role of PCPs in screening decisions (from paternalistic to informed decision-making) and correct answer to a clinical vignette.

RESULTS: Before the seminars, 8% of PCPs reported that they had equal proportions of their patients screened for CRC by FIT and colonoscopy; after the seminar, 33% foresaw having their patients screened in equal proportions (p<0.001). Among those not attending, there was no change (13% vs 14%, p=0.8). Of those attending, there was no change in their perceived role in screening decisions, while the proportion responding correctly to a clinical vignette increased (88-99%, p<0.001).

CONCLUSIONS: An interactive training seminar increased the proportion of physicians with the intention to prescribe FIT and colonoscopy in equal proportions.

Alternate URL

http://www.ncbi.nlm.nih.gov/pubmed/27178977?dopt=Abstract

WOS ID (UT)

000378414700111

Alternate JournalBMJ Open
Citation Key / SERVAL ID7167
PubMed ID27178977
PubMed Central IDPMC4874168

                         

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