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Should I Take Aspirin? (SITA): randomised controlled trial of a decision aid for cancer chemoprevention.
Onwuka, Shakira R; McIntosh, Jennifer; Macrae, Finlay; Chondros, Patty; Boyd, Lucy; Wijesuriya, Rushani; Saya, Sibel; Karnchanachari, Napin; Novy, Kitty; Jenkins, Mark A; Walter, Fiona M; Trevena, Lyndal; Gutierrez, Javiera Martinez; Broun, Kate; Fishman, George; Marker, Julie; Emery, Jon.
Afiliação
  • Onwuka SR; Centre for Cancer Research, University of Melbourne; Department of General Practice and Primary Care, University of Melbourne; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
  • McIntosh J; Centre for Cancer Research, University of Melbourne; Department of General Practice and Primary Care, University of Melbourne; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
  • Macrae F; Colorectal Medicine and Genetics, Royal Melbourne Hospital, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia.
  • Chondros P; Department of General Practice and Primary Care, University of Melbourne, Melbourne, Australia.
  • Boyd L; Centre for Cancer Research, University of Melbourne; Department of General Practice and Primary Care, University of Melbourne, Melbourne, Australia.
  • Wijesuriya R; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia.
  • Saya S; Centre for Cancer Research, University of Melbourne; Department of General Practice and Primary Care, University of Melbourne, Melbourne, Australia.
  • Karnchanachari N; Centre for Cancer Research, University of Melbourne; Department of General Practice and Primary Care, University of Melbourne, Melbourne, Australia.
  • Novy K; Centre for Cancer Research, University of Melbourne; Department of General Practice and Primary Care, University of Melbourne, Melbourne, Australia.
  • Jenkins MA; National Health and Medical Research Council Professorial Fellow, cancer epidemiologist, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
  • Walter FM; Wolfson Institute of Population Health, Queen Mary University of London, London, UK; professor of primary care cancer research, Department of General Practice and Primary Care, University of Melbourne, Melbourne, Australia.
  • Trevena L; Primary Health Care, School of Public Health, University of Sydney, Sydney, Australia.
  • Gutierrez JM; Centre for Cancer Research, University of Melbourne; Department of General Practice and Primary Care, University of Melbourne, Melbourne, Australia; School of Medicine, Family Medicine Department, Pontificia Universidad Católica de Chile, Santiago, Chile.
  • Broun K; Prevention Division, Cancer Council Victoria, Melbourne, Australia.
  • Fishman G; PC4 Joint Community Advisory Group, University of Melbourne, Melbourne, Australia.
  • Marker J; PC4 Joint Community Advisory Group, University of Melbourne, Melbourne, Australia.
  • Emery J; Centre for Cancer Research, University of Melbourne; Department of General Practice and Primary Care, University of Melbourne, Melbourne, Australia; Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Br J Gen Pract ; 74(745): e498-e507, 2024 Aug.
Article em En | MEDLINE | ID: mdl-38527793
ABSTRACT

BACKGROUND:

Australian guidelines recommend that people aged 50-70 years consider taking low-dose aspirin to reduce their risk of colorectal cancer (CRC).

AIM:

To determine the effect of a consultation with a researcher before an appointment in general practice using a decision aid presenting the benefits and harms of taking low-dose aspirin compared with a general CRC prevention brochure on patients' informed decision making and low-dose aspirin use. DESIGN AND

SETTING:

Individually randomised controlled trial in six general practices in Victoria, Australia, from October 2020 to March 2021.

METHOD:

Participants were recruited from a consecutive sample of patients aged 50-70 years attending a GP. The intervention was a consultation using a decision aid to discuss taking aspirin to reduce CRC risk while control consultations discussed reducing CRC risk generally. Self-reported co-primary outcomes were the proportion of individuals making informed choices about taking aspirin at 1 month and on low-dose aspirin uptake at 6 months, respectively. The intervention effect was estimated using a generalised linear model and reported with Bonferroni-adjusted 95% confidence intervals (CIs) and P-values.

RESULTS:

A total of 261 participants (86% of eligible patients) were randomised into trial arms (n = 129 intervention; n = 132 control). Of these participants, 17.7% (n = 20/113) in the intervention group and 7.6% (n = 9/118) in the control group reported making an informed choice about taking aspirin at 1 month, an estimated 9.1% (95% CI = 0.29 to 18.5) between-arm difference in proportions (odds ratio [OR] 2.47, 97.5% CI = 0.94 to 6.52, P = 0.074). The proportions of individuals who reported taking aspirin at 6 months were 10.2% (n = 12/118) of the intervention group versus 13.8% (n = 16/116) of the control group, an estimated between-arm difference of -4.0% (95% CI = -13.5 to 5.5; OR 0.68 [97.5% CI = 0.27 to 1.70, P = 0.692]).

CONCLUSION:

The decision aid improved informed decision making but this did not translate into long-term regular use of aspirin to reduce CRC risk. In future research, decision aids should be delivered alongside various implementation strategies.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Colorretais / Aspirina / Técnicas de Apoio para a Decisão País/Região como assunto: Oceania Idioma: En Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Austrália
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Colorretais / Aspirina / Técnicas de Apoio para a Decisão País/Região como assunto: Oceania Idioma: En Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Austrália