None listed
Conditions
Brief summary
This study aims to pilot a general practice-led intervention to increase participation in the National Bowel Cancer Screening Program (NBCSP) within 100 general practices in two Australian states. Who is it for? You may be eligible for this study if you are an adult aged 45 years or older who is a patient at one of the participating general practice (GP) clinics and you are eligible for bowel cancer screening. Please note that the primary participants in this study are the GPs, however patients may be involved during the study whilst the screening initiatives are being trialled. Study details Participating GPs who agree to participate in this trial will be asked to continue their usual bowel cancer screening procedures for the first 5 months of this study. After 5 months, GP clinics will be randomly allocated by chance (similar to flipping a coin) to one of two groups. GPs who are allocated to the first group will be asked to incorporate a variety of strategies aimed at increasing the number of patients who take up bowel cancer screening opportunities. These strategies have been co-designed prior to the current trial and include the use of decision support tools, reminder prompts, additional education focusing on appropriate screening pathways and communication guides to address screening barriers in non-participant patients. Patients who attend one of the participating GP clinics may be exposed to one or more of these strategies during the trial period. GPs who are allocated to the second group will be asked to continue their usual bowel cancer screening procedures for the duration of the study and will not be given access to the new strategies and tools at this time. It is hoped this research will determine whether including new tools and educational materials into routine care for bowel cancer screening that occurs through GP clinics has a positive impact on the number of patients who undergo bowel cancer screening. If this trial shows that any of the strategies used are effective at increasing screening, they may be expanded to all GP clinics at a national level.
Interventions
The ‘general practice-led intervention’ is a multi-component intervention identified in a synthesised evidence review of interventions effective at increasing Colorectal Cancer (CRC) screening participation and co-designed with general practice staff.
The co-design was completed in April 2023 with 38 General Practice Staff and from across Australia. Co-design participants discussed implementation barriers and enablers of intervention components with evidence-based effectiveness at increasing C
The ‘general practice-led intervention’ is a multi-component intervention identified in a synthesised evidence review of interventions effective at increasing Colorectal Cancer (CRC) screening participation and co-designed with general practice staff. The co-design was completed in April 2023 with 38 General Practice Staff and from across Australia. Co-design participants discussed implementation barriers and enablers of intervention components with evidence-based effectiveness at increasing CRC screening. The co-design results were analyzed against implementation science frameworks and the barriers assessed against implementation barriers identified in the evidence review. The final intervention to be delivered to general practice healthcare providers will comprise of a combination of the following components: 1. Decision-aid tools adapted from existing sources. Anticipated completion time of 5 minutes per patient. 2. Reminder prompts activated within existing general practice software Medical Director 3. Integration of the National Cancer Screening Register (NCSR) within practice software systems and use of a Cancer Screening Toolkit and clinical audits of patient data based on existing resources used in the participating states. Anticipated time by practice staff 1 hr per fortnight for 6-month duration. 4. Learning modules and digital resources to educate on guideline-appropriate screening pathways for GPs: - 2 x 1 hour online self-paced modules developed by GPEx with the learning outcomes: - Be aware why General Practice needs to endorse participation in the National Bowel Cancer Screening Program and be able to explain to patients the risks in not completing the test. - Be familiar with the impact GPs can have on bowel cancer screening rates. - Have access to the resources your practice needs to encourage patients to screen for bowel cancer. - Have increased knowledge of key points from the national colorectal guidelines and links to further clinical information. All intervention components will be offered to practices allocated to the intervention arm of the trial however practice participants may choose to adhere to a minimum of one component. Clinical Trial Coordinators will support the implementation of and adherence to intervention components within practice with the use of strategies inclusive of identifying practice champions and reminding participants about the components. The Clinical Trial Coordinators will provide participants education on how to use the intervention components and ongoing support and training for participants throughout the trial. The Clinical Trial Coordinators will be trained in strategies to improve the implementation of interventions in the primary healthcare setting. The trial will commence in September 2024. The intervention will be provided after an initial five months of usual care and data collection - from Feb 2025. The intervention exposure period is four months and cease at end May 2025.
Sponsors
University of Sydney
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
45 Years to 74 Years
Healthy volunteers
Yes
Inclusion criteria
General Practices inclusion criteria: • Has at least two GPs (FTE) willing to participate in the trial • Nominated Practice Champion who is willing and able to liaise with the Daffodil Centre research team • Uses Medical Director or Best Practice software • Uses Pen CS, Polar or Primary Sense • Available over the trial period Sept 2024 – May 2025 • Windows 10 or higher, i5/i7 16GB processing or willing to upgrade • Has over 1000 active patients and sees minimum of 35 adult patients per day Adult patient inclusion criteria: Inclusion criteria • General Practice patients aged 45 to 74 years
Exclusion criteria
General Practice exclusion criteria: • Shares server with another practice • Uses paper-based medical records • Does not share data with PHN Adult patient exclusion criteria: Exclusion criteria • Under 45 or over 74 years • Previous or current diagnosis of CRC • Previous or current diagnosis of inflammatory bowel disease – e.g., ulcerative colitis or Chron’s disease Familial syndrome associated with increased risk of CRC: lynch syndrome, familial adenomatous polyposis (FAP), attenuated FAP (AFAP), MUTYH-associated polyposis, polymerase proof-reading associated polyposis (PPAP), NTHL1-associated polyposis (NAP), Peutz-Jeghers syndrome, Juvenile polyposis syndrome, Serrated polyposis syndrome, and Cowden syndrome
Outcome results
None listed