Alerts in electronic medical records to promote a colorectal cancer screening programme: a cluster randomised controlled trial in primary care

Guiriguet, Carolina; Muñoz-Ortíz, Laura; Burón, Andrea; Rivero, Irene; Grau, Jaume; Vela-Vallespín, Carmen; Vilarrubí, Mercedes; Torres, Mauricio Plaza; Hernández, Cristina; Méndez-Boo, Leonardo; Torán, Pere; Caballería, Llorenç; Macià, Francesc; Castells, Antoni

doi:10.3399/bjgp16x685657

Cited by 33 publications

(23 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1 Flowchart of the study. 1 Corresponding to individuals involved in the cluster randomized controlled trial Colo-alert (see reference [ 19 ]). 2 Colonoscopy performed in the last five years or faecal occult blood test in the last two years.…”

Section: Methodsmentioning

confidence: 99%

“…The Colo-alert trial was a cluster randomised clinical trial (RCT) in primary care, that evaluated the effectiveness of an alert in the electronic medical record (intervention group) to encourage colorectal cancer screening participation compared to usual care (control group) in which primary care professionals were involved in order to improve colorectal cancer screening participation [ 19 ]. The BCCSP was launched in December 2009 and the first round lasted until May 2012.…”

Section: Methodsmentioning

confidence: 99%

“…Other adjusting explanatory variables were age, sex, body mass index (BMI), smoking status (never smoked, ex-smoker, current smoker), alcohol consumption (non-drinker, low-risk drinker, high-risk drinker), socioeconomic deprivation index, number of visits to primary care during the follow-up period (1 year) and the study group to which individuals were allocated in the Colo-alert study [ 19 ] (control or intervention). BMI was grouped into three categories comprising low-normal weight (<25 kg/m 2 ), overweight (25–29.9 kg/m 2 ) and obesity (≥30 kg/m 2 ).…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Impact of comorbid conditions on participation in an organised colorectal cancer screening programme: a cross-sectional study

et al. 2017

Self Cite

View full text Add to dashboard Cite

BackgroundThere is controversy regarding how comorbidity impacts on colorectal cancer screening, especially in the context of organised programmes. The aim of this study is to assess the effect of comorbidities on participation in the Barcelona population-based colorectal cancer screening programme (BCCSP).MethodsCross-sectional study carried out in ten primary care centres involved in the BCCSP. Individuals aged 50 to 69, at average risk of colorectal cancer, who were invited to participate in the first round of the faecal immunochemical test-based BCCSP were included (2011–2012). The main variable was participation in the BCCSP. Comorbidity was assessed by clinical risk group status. Other adjusting variables were age, sex, socioeconomic deprivation, visits to primary care, smoking, alcohol consumption and body mass index. Logistic regression models were used to test the association between participation in the programme and potential explanatory variables. The results were given as incidence rate ratios (IRR) and their 95% confidence intervals (CI).ResultsOf the 36,208 individuals included, 17,404 (48%) participated in the BCCSP. Participation was statistically significantly higher in women, individuals aged 60 to 64, patients with intermediate socioeconomic deprivation, and patients with more medical visits. There was a higher rate of current smoking, high-risk alcohol intake, obesity and individuals in the highest comorbidity categories in the non-participation group. In the adjusted analysis, only individuals with multiple minor chronic diseases were more likely to participate in the BCCSP (IRR 1.14; 95% CI [1.06 to 1.22]; p < 0.001). In contrast, having three or more dominant chronic diseases was associated with lower participation in the screening programme (IRR 0.76; 95% CI [0.65 to 0.89]; p = 0.001).ConclusionsHaving three or more dominant chronic diseases, was associated with lower participation in a faecal immunochemical test-based colorectal cancer screening programme, whereas individuals with multiple minor chronic diseases were more likely to participate. Further research is needed to explore comorbidity as a cause of non-participation in colorectal cancer screening programmes and which individuals could benefit most from colorectal cancer screening.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Impact of comorbid conditions on participation in an organised colorectal cancer screening programme: a cross-sectional study

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…The use of an alert in an individual’s primary care electronic medical records is associated with a significantly increased uptake of an organized, FIT-based CRC screening program in patients attending primary care centers 42.…”

Section: Reminder Systemsmentioning

confidence: 99%

Screening for colorectal cancer: the role of the primary care physician

Triantafillidis

Vagianos

Gikas³

et al. 2017

European Journal of Gastroenterology &Amp; Hepatology

View full text Add to dashboard Cite

In recent years, the role of primary care physicians (PCPs) in the diagnosis and management of gastrointestinal disorders, including screening for colorectal cancer (CRC), has been recognized as very important. The available data indicate that PCPs are not adequately following CRC screening guidelines because a number of factors have been identified as significant barriers to the proper application of CRC screening guidelines. These factors include lack of time, patient reluctance, and challenges related to scheduling colonoscopy. Further positive engagement of PCPs with CRC screening is required to overcome these barriers and reach acceptable levels in screening rates. To meet the expectations of modern medicine, PCPs should not only be able to recommend occult blood testing or colonoscopy but also, under certain conditions, able to perform colonoscopy. In this review, the authors aim to provide the current knowledge of the role of PCPs in increasing the rate and successfully implementing a screening program for CRC by applying the relevant international guidelines.

show abstract

“…A Cochrane review by Shojania et al [4] found that electronic reminders had a modest effect on process adherence (median improvement of 4.2%), while a systematic review and meta-analysis by Holt et al [5] found an overall odds ratio of 1.79 (95% CI: 1.56-2.05) for computergenerated on-screen and paper reminders. Most studies of the effectiveness of reminders in primary care settings have analyzed systems targeting a single disorder or clinical condition [6][7][8][9][10][11][12][13]. The few studies of multiple reminder interventions have mostly focused on vaccination, screening, and adverse drug events [14,15].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of electronic point-of-care reminders versus monthly feedback to improve adherence to 10 clinical recommendations in primary care: a cluster randomized clinical trial

Coma

Medina

Méndez

et al. 2019

BMC Med Inform Decis Mak

View full text Add to dashboard Cite

BackgroundNumerous studies have analyzed the effectiveness of electronic reminder interventions to improve different clinical conditions, and most have reported a small to moderate effect. Few studies, however, have analyzed reminder systems targeting multiple conditions, and fewer still have compared electronic point-of-care reminders systems with other forms of feedback designed to improve delivery of care.MethodsWe performed an unblinded cluster randomized clinical trial to compare the effectiveness of an electronic point-of-care reminder system with that of a well-established system providing monthly feedback on adherence to clinical recommendations. The control group received monthly feedback only while the intervention group received monthly feedback in addition to on-screen point-of-care reminders for 10 clinical conditions. The study targeted all physicians and nurses at the 283 primary care centers managed by the Institut Català de la Salut (approximately 6600 professionals).ResultsFollowing exclusions and randomization, 132 primary care centers (328,728 patients with reminders) were assigned to the intervention group while 137 centers (317,117 patients with reminders) were randomized to the control group. A 20.6% improvement (OR 1.29, 95% CI: 1.25–1.34) in reminder resolution rates was observed in the intervention group. Results varied according to the clinical condition. The most effective reminder was screening for diabetic retinopathy (OR 1.51, 95% CI:1.46–1.57) while the least effective reminders were measurement of glycated hemoglobin (OR: 1.10, 95% CI: 1.07–1.13) and smoking cessation encouragement (OR 1.12, 95% CI: 1.09–1.16).ConclusionsElectronic point-of-care reminders were more effective than the existing monthly feedback system at resolving the 10 clinical situations. However, more studies are needed to investigate the variations of the effect observed.Trial registrationCurrent Controlled Trials ISRCTN42391639, 08/10/2012. Retrospectively registered.

show abstract

Alerts in electronic medical records to promote a colorectal cancer screening programme: a cluster randomised controlled trial in primary care

Cited by 33 publications

References 34 publications

Impact of comorbid conditions on participation in an organised colorectal cancer screening programme: a cross-sectional study

Impact of comorbid conditions on participation in an organised colorectal cancer screening programme: a cross-sectional study

Screening for colorectal cancer: the role of the primary care physician

Effectiveness of electronic point-of-care reminders versus monthly feedback to improve adherence to 10 clinical recommendations in primary care: a cluster randomized clinical trial

Contact Info

Product

Resources

About