Effect of a Digital Health Intervention on Receipt of Colorectal Cancer Screening in Vulnerable Patients: A Randomized Controlled Trial.
Ann Intern Med
; 168(8): 550-557, 2018 04 17.
Article
in En
| MEDLINE
| ID: mdl-29532054
ABSTRACT
Background:
Screening for colorectal cancer (CRC) reduces mortality, yet more than one third of age-eligible Americans are unscreened.Objective:
To examine the effect of a digital health intervention, Mobile Patient Technology for Health-CRC (mPATH-CRC), on rates of CRC screening.Design:
Randomized clinical trial. (ClinicalTrials.gov NCT02088333).Setting:
6 community-based primary care practices.Participants:
450 patients (223 in the mPATH-CRC group and 227 in usual care) scheduled for a primary care visit and due for routine CRC screening. Intervention An iPad application that displays a CRC screening decision aid, lets patients order their own screening tests, and sends automated follow-up electronic messages to support patients. Measurements The primary outcome was chart-verified completion of CRC screening within 24 weeks. Secondary outcomes were ability to state a screening preference, intention to receive screening, screening discussions, and orders for screening tests. All outcome assessors were blinded to randomization.Results:
Baseline characteristics were similar between groups; 37% of participants had limited health literacy, and 53% had annual incomes less than $20 000. Screening was completed by 30% of mPATH-CRC participants and 15% of those receiving usual care (logistic regression odds ratio, 2.5 [95% CI, 1.6 to 4.0]). Compared with usual care, more mPATH-CRC participants could state a screening preference, planned to be screened within 6 months, discussed screening with their provider, and had a screening test ordered. Half of mPATH-CRC participants (53%; 118 of 223) "self-ordered" a test via the program.Limitation:
Participants were English speakers in a single health care system.Conclusion:
A digital health intervention that allows patients to self-order tests can increase CRC screening. Future research should identify methods for implementing similar interventions in clinical care. Primary Funding Source National Cancer Institute.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Colorectal Neoplasms
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Mass Screening
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Vulnerable Populations
/
Early Detection of Cancer
/
Mobile Applications
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Prognostic_studies
/
Screening_studies
Limits:
Aged
/
Female
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Humans
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Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
Ann Intern Med
Year:
2018
Document type:
Article