Improving Compliance With Medical Testing Guidelines

Beth Israel Lahey Health

Status: Completed

Conditions: Breast Cancer; Colon Cancer; Lung Cancer; Prostate Cancer; Cervical Cancer

Treatments: Other: Academic detailing; Other: Standard support; Other: No academic detailing; Other: Color-coded materials

Study type: Interventional

Funder types: Other

Identifiers

NCT02430948

OGARA CAN-264

Details and patient eligibility

About

The study hypothesis is that clearer visual presentation of guideline recommendations and educational outreach, or academic detailing, can improve guideline compliance. However, it will investigate other aspects of screening-related decision-making, such as provider and patient beliefs about screening, provider-patient communication and patient's willingness to forgo expected testing. The research question is whether educational interventions can decrease non-compliance with screening guidelines for 5 common cancers.

Full description

This study is a cluster randomized trial that compares the immediate post-encounter impressions of 12 physicians and 18 of their patients about the discussion of screening for breast, cervical, colorectal, lung and prostate cancer as well as their beliefs about screening efficacy and patient reports of the screening experience. The interventions are educational materials and academic detailing (educational outreach) for providers. The investigators are particularly interested in contrasting the patient and provider recollections, the differential impact on underuse and overuse compliance and whether patient behaviors are consistent with their stated screening plans.

Enrollment: 218 patients

Sex: All

Ages: 30 to 89 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patients: healthy men and women ages 30-89 seeing their primary care provider for routine visit
• Providers: non-pediatric primary care physicians from Mount Sinai Beth Israel or St. Luke's-Roosevelt associated practices

Exclusion criteria

• Patient life expectancy of less than 1 year in primary care provider's judgment
• Inability to read and understand English
• Transgender status

Trial design

Primary purpose: Screening

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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218 participants in 4 patient groups

Standard Support Outreach

Active Comparator group

Description:

Providers receive standard written screening recommendations and do not receive academic detailing (educational outreach)

Treatment:

Other: Standard support

Other: No academic detailing

Standard materials and academic detailing

Experimental group

Description:

Providers receive standard written screening recommendations and receive academic detailing (educational outreach)

Treatment:

Other: Standard support

Other: Academic detailing

Color-coded materials and no academic detailing

Experimental group

Description:

Providers receive color-coded written screening recommendations and do not receive academic detailing (educational outreach)

Treatment:

Other: Color-coded materials

Other: No academic detailing

Color-coded materials and academic detailing

Experimental group

Description:

Providers receive color-coded written screening recommendations and receive academic detailing (educational outreach)

Treatment:

Other: Color-coded materials

Other: Academic detailing