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PMID- 28873160
OWN - NLM
STAT- In-Process
DA  - 20170905
LR  - 20170905
IS  - 1538-3598 (Electronic)
IS  - 0098-7484 (Linking)
VI  - 318
IP  - 9
DP  - 2017 Sep 05
TI  - Effect of Physician Notification Regarding Nonadherence to Colorectal Cancer
      Screening on Patient Participation in Fecal Immunochemical Test Cancer Screening:
      A Randomized Clinical Trial.
PG  - 816-824
LID - 10.1001/jama.2017.11387 [doi]
AB  - Importance: Increasing participation in fecal screening tests is a major
      challenge in countries that have implemented colorectal cancer (CRC) screening
      programs. Objective: To determine whether providing general practitioners (GPs) a
      list of patients who are nonadherent to CRC screening enhances patient
      participation in fecal immunochemical testing (FIT). Design, Setting, and
      Participants: A 3-group, cluster-randomized study was conducted from July 14,
      2015, to July 14, 2016, on the west coast of France, with GPs in 801 practices
      participating and involving adult patients (50-74 years) who were at average risk
      of CRC and not up-to-date with CRC screening. The final follow-up date was July
      14, 2016. Interventions: General practitioners were randomly assigned to 1 of 3
      groups: 496 received a list of patients who had not undergone CRC screening
      (patient-specific reminders group, 10476 patients), 495 received a letter
      describing region-specific CRC screening adherence rates (generic reminders
      group, 10606 patients), and 455 did not receive any reminders (usual care group, 
      10147 patients). Main Outcomes and Measures: The primary end point was patient
      participation in CRC screening 1 year after the intervention. Results: Among 1482
      randomized GPs (mean age, 53.4 years; 576 women [38.9%]), 1446 participated; of
      the 33044 patients of these GPs (mean age, 59.7 years; 17949 women [54.3%]),
      follow-up at 1 year was available for 31229 (94.5%). At 1 year, 24.8% (95% CI,
      23.4%-26.2%) of patients in the specific reminders group, 21.7% (95% CI,
      20.5%-22.8%) in the generic reminders group, and 20.6% (95% CI, 19.3%-21.8%) in
      the usual care group participated in the FIT screening. The between-group
      differences were 3.1% (95% CI, 1.3%-5.0%) for the patient-specific reminders
      group vs the generic reminders group, 4.2% (95% CI, 2.3%-6.2%) for the
      patient-specific reminders group vs the usual care group, and 1.1% (95% CI, -0.6%
      to 2.8%) for generic reminders group vs the usual care group. Conclusions and
      Relevance: Providing French GPs caring for adults at average risk of CRC with a
      list of their patients who were not up-to-date with their CRC screening resulted 
      in a small but significant increase in patient participation in FIT screening at 
      1 year compared with patients who received usual care. Providing GPs with generic
      reminders about regional rates of CRC screening did not increase screening rates 
      compared with usual care. Trial Registration: clinicaltrials.gov Identifier:
      NCT02515344.
FAU - Rat, Cedric
AU  - Rat C
AD  - Department of General Practice, Faculty of Medicine, Nantes, France.
AD  - French National Institute of Health and Medical Research, INSERM U1232 - Team 2, 
      Nantes, France.
FAU - Pogu, Corinne
AU  - Pogu C
AD  - Association in charge of colorectal cancer screening program, CAPSANTE 44,
      Nantes, France.
FAU - Le Donne, Delphine
AU  - Le Donne D
AD  - Department of General Practice, Faculty of Medicine, Nantes, France.
FAU - Latour, Chloe
AU  - Latour C
AD  - Department of General Practice, Faculty of Medicine, Nantes, France.
FAU - Bianco, Gaelle
AU  - Bianco G
AD  - Association in charge of colorectal cancer screening program, AUDACE, La Roche
      sur Yon, France.
FAU - Nanin, France
AU  - Nanin F
AD  - French Health Insurance System, Division of Nantes, Nantes, France.
FAU - Cowppli-Bony, Anne
AU  - Cowppli-Bony A
AD  - Cancer registry for Loire-Atlantique and Vendee geographic areas, Nantes, France.
FAU - Gaultier, Aurelie
AU  - Gaultier A
AD  - Department of Epidemiology and Biostatistics, Nantes University Hospital, Nantes,
      France.
FAU - Nguyen, Jean-Michel
AU  - Nguyen JM
AD  - French National Institute of Health and Medical Research, INSERM U1232 - Team 2, 
      Nantes, France.
AD  - Department of Epidemiology and Biostatistics, Nantes University Hospital, Nantes,
      France.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - JAMA
JT  - JAMA
JID - 7501160
EDAT- 2017/09/06 06:00
MHDA- 2017/09/06 06:00
CRDT- 2017/09/06 06:00
AID - 2652649 [pii]
AID - 10.1001/jama.2017.11387 [doi]
PST - ppublish
SO  - JAMA. 2017 Sep 5;318(9):816-824. doi: 10.1001/jama.2017.11387.