Quality Improvement of Patient-Provider Communication For Colorectal Cancer Screening

Colorectal Cancer Clinical Trial

Official title:

Improving Patient-Provider Communication For Colorectal Cancer Screening

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00324753
• Other study ID #: IIR 03-252
• Status: Completed
• Phase: N/A
• Start date: April 2007
• Est. completion date: June 2010

Study information

• Verified date: November 2018
• Source: VA Office of Research and Development
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The immediate objective of this proposal is to assess the effectiveness of a multi-faceted intervention to improve patient-provider communication about colorectal cancer screening in improving patient adherence with colorectal cancer screening recommendations. This intervention consists of: (1) guiding the communication process through patient activation to initiate a colorectal cancer screening discussion; (2) optimizing communication content through the use of a prompt sheet; and (3) cueing the provider to assess patient perception of the communication. The long-term objective of our research program is to maximize colorectal cancer screening rates throughout the VA through widespread adoption of clinically feasible approaches to enhance patient-provider communication.

Description:

In the United States, colorectal cancer is the third most common cancer and the second leading cause of cancer mortality with over 56,000 deaths in 2004). Early detection through screening decreases the mortality associated with the disease. However, adherence with current screening recommendations is low. A survey of the general population indicates that only 53.1% of Americans, age 50 years and older for whom colorectal cancer screening is recommended, are up-to-date with this preventive service. While colorectal cancer screening rates with the VA Healthcare System (VHA) are better than in the general population (75% in Fiscal Year (FY) 2005), they are lower than performance rates for other types of cancer screening (e.g., mammography) in VHA. Further, numerous VA medical centers report colorectal cancer screening rates below the level considered satisfactory.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 454
• Est. completion date: June 2010
• Est. primary completion date: June 2010
• Accepts healthy volunteers: No
• Gender: All
• Age group: 50 Years to 74 Years

Eligibility

Inclusion Criteria:

Provider Eligibility:

• Primary care providers (MD, Certified Registered Nurse Practitioner (CRNP), or PA) at the study sites who see patients in the primary care setting at least 1 day per week and had no involvement in the design of the study are eligible for enrollment in the study.

Patient Eligibility:

• Primary care patients who are not "up-to-date" with colorectal cancer screening are the targeted population for study enrollment.

• Up-to-date with colorectal cancer screening is defined as having completed one of the following:

• fecal occult blood testing within the past year

• sigmoidoscopy within the past 5 years

• colonoscopy within the past 10 years

• barium enema within the past 5 years.

• Other patient eligibility criteria are:

• Primary Care Provider (PCP) enrolled in the study

• clinic visit scheduled with the enrolled PCP during the recruitment period

• English speaking

• no prior history of colorectal cancer or adenomatous polyps

• no prior history of inflammatory bowel disease

Exclusion Criteria:

• Patients who are deemed clinically not appropriate for colorectal cancer screening due to severe comorbidity and/or limited life expectancy as determined by the patient's primary care provider will be excluded from the study.

Related Conditions & MeSH terms

• Colorectal Cancer
• Colorectal Neoplasms

Intervention

Behavioral:
• Communication
Communication sheet
• Standard of care
Standard of care brochures

Locations

Country	Name	City	State
United States	Jesse Brown VA Medical Center, Chicago, IL	Chicago	Illinois
United States	Michael E. DeBakey VA Medical Center, Houston, TX	Houston	Texas
United States	VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA	Pittsburgh	Pennsylvania

Sponsors (1)

Lead Sponsor	Collaborator
VA Office of Research and Development

Country where clinical trial is conducted

United States, 

References & Publications (1)

Ling BS, Trauth JM, Fine MJ, Mor MK, Resnick A, Braddock CH, Bereknyei S, Weissfeld JL, Schoen RE, Ricci EM, Whittle J. Informed decision-making and colorectal cancer screening: is it occurring in primary care? Med Care. 2008 Sep;46(9 Suppl 1):S23-9. doi: — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Completion of Colorectal Cancer Screening Tests	A survey collected data on patient demographic characteristics, family history of colorectal cancer or polyp, and provider recommendation for colorectal cancer screening, if any. In addition, we asked patients whether colorectal cancer screening was discussed at the visit. If the response was yes, we then asked patients how satisfied they were with the PCP communication during the visit in general using a 5-point Likert scale to a number of items describing the communication. A medical record review was conducted to collect data on provider ordering and patient completion of the following colorectal cancer screening tests during the study period (i.e., 6 months from the time of the clinical encounter): fecal occult blood testing, sigmoidoscopy, or colonoscopy.	6-12 months
Primary	Quality of Communication	Patient satisfaction with the discussion of Colorectal Cancer (CRC) screening with the primary care provider (PCP).	immediate after the patient visit
Primary	Communication Content	PCP Explains CRC screening to my satisfaction	immediately after the patient visit

External Links

•   Click here for more information about this study: Improving Patient-Provider Communication For Colorectal Cancer Screening