Efficacy of a Telehealth Intervention on Colonoscopy Uptake When Cost Is a Barrier: The Family CARE Cluster Randomized Controlled Trial.
Cancer Epidemiol Biomarkers Prev
; 24(9): 1311-8, 2015 Sep.
Article
em En
| MEDLINE
| ID: mdl-26101306
ABSTRACT
BACKGROUND:
We tested the efficacy of a remote tailored intervention Tele-Cancer Risk Assessment and Evaluation (TeleCARE) compared with a mailed educational brochure for improving colonoscopy uptake among at-risk relatives of colorectal cancer patients and examined subgroup differences based on participant reported cost barriers.METHODS:
Family members of colorectal cancer patients who were not up-to-date with colonoscopy were randomly assigned as family units to TeleCARE (N = 232) or an educational brochure (N = 249). At the 9-month follow-up, a cost resource letter listing resources for free or reduced-cost colonoscopy was mailed to participants who had reported cost barriers and remained nonadherent. Rates of medically verified colonoscopy at the 15-month follow-up were compared on the basis of group assignment and within group stratification by cost barriers.RESULTS:
In intent-to-treat analysis, 42.7% of participants in TeleCARE and 24.1% of participants in the educational brochure group had a medically verified colonoscopy [OR, 2.37; 95% confidence interval (CI) 1.59-3.52]. Cost was identified as a barrier in both groups (TeleCARE = 62.5%; educational brochure = 57.0%). When cost was not a barrier, the TeleCARE group was almost four times as likely as the comparison to have a colonoscopy (OR, 3.66; 95% CI, 1.85-7.24). The intervention was efficacious among those who reported cost barriers; the TeleCARE group was nearly twice as likely to have a colonoscopy (OR, 1.99; 95% CI, 1.12-3.52).CONCLUSIONS:
TeleCARE increased colonoscopy regardless of cost barriers. IMPACT Remote interventions may bolster screening colonoscopy regardless of cost barriers and be more efficacious when cost barriers are absent.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
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Vigilância da População
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Colonoscopia
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Cooperação do Paciente
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Telemedicina
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Health_economic_evaluation
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Prognostic_studies
/
Risk_factors_studies
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Screening_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Cancer Epidemiol Biomarkers Prev
Ano de publicação:
2015
Tipo de documento:
Article