Article Text

Download PDFPDF

Training primary care physicians to offer their patients faecal occult blood testing and colonoscopy for colorectal cancer screening on an equal basis: a pilot intervention with before–after and parallel group surveys
  1. Kevin Selby1,
  2. Jacques Cornuz1,
  3. David Gachoud2,3,
  4. Jean-Luc Bulliard4,
  5. Cristina Nichita5,
  6. Gian Dorta5,
  7. Cyril Ducros6,
  8. Reto Auer1,7
  1. 1Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
  2. 2Department of Internal Medicine, University Hospital of Lausanne, Lausanne, Switzerland
  3. 3Education Unit, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
  4. 4Institute of Social and Preventive Medicine, University Hospital of Lausanne, Lausanne, Switzerland
  5. 5Department of Gastroenterology and Hepatology, University Hospital of Lausanne, Lausanne, Switzerland
  6. 6Canton of Vaud Foundation for Cancer Screening, Lausanne, Switzerland
  7. 7Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
  1. Correspondence to Dr Kevin Selby; kevin.selby{at}hospvd.ch

Abstract

Objectives Primary care physicians (PCPs) should prescribe faecal immunochemical testing (FIT) or colonoscopy for colorectal cancer screening based on their patient's values and preferences. However, there are wide variations between PCPs in the screening method prescribed. The objective was to assess the impact of an educational intervention on PCPs’ intent to offer FIT or colonoscopy on an equal basis.

Design Survey before and after training seminars, with a parallel comparison through a mailed survey to PCPs not attending the training seminars.

Setting All PCPs in the canton of Vaud, Switzerland.

Participants Of 592 eligible PCPs, 133 (22%) attended a seminar and 106 (80%) filled both surveys. 109 (24%) PCPs who did not attend the seminars returned the mailed survey.

Intervention A 2 h-long interactive seminar targeting PCP knowledge, skills and attitudes regarding offering a choice of colorectal cancer (CRC) screening options.

Outcome measures The primary outcome was PCP intention of having their patients screened with FIT and colonoscopy in equal proportions (between 40% and 60% each). Secondary outcomes were the perceived role of PCPs in screening decisions (from paternalistic to informed decision-making) and correct answer to a clinical vignette.

Results Before the seminars, 8% of PCPs reported that they had equal proportions of their patients screened for CRC by FIT and colonoscopy; after the seminar, 33% foresaw having their patients screened in equal proportions (p<0.001). Among those not attending, there was no change (13% vs 14%, p=0.8). Of those attending, there was no change in their perceived role in screening decisions, while the proportion responding correctly to a clinical vignette increased (88–99%, p<0.001).

Conclusions An interactive training seminar increased the proportion of physicians with the intention to prescribe FIT and colonoscopy in equal proportions.

  • PRIMARY CARE
  • MEDICAL EDUCATION & TRAINING

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.