Improving Compliance With Medical Testing Guidelines

Not Applicable

Completed

• Conditions: Colon Cancer; Breast Cancer; Cervical Cancer; Lung Cancer; Prostate Cancer
• Interventions: Other: Color-coded materials; Other: Academic detailing; Other: No academic detailing; Other: Standard support

• Registration Number: NCT02430948
• Lead Sponsor: Beth Israel Medical Center

Brief Summary

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.

Detailed 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.

Study Timeline

• Study Start: 2014-01
• Study First Submitted: 2014-09-29
• Study First Submitted QC: 2015-04-27
• Study First Posted: 2015-04-30
• Primary Completion: 2017-02
• Study Completion: 2017-02
• Status Verified: 2019-07
• Last Update Submitted: 2019-07-25
• Last Update Posted: 2019-07-26

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 218

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: FACTORIAL

Arm && Interventions

Group	Intervention	Description
Standard Support Outreach	No academic detailing	Providers receive standard written screening recommendations and do not receive academic detailing (educational outreach)
Color-coded materials and no academic detailing	Color-coded materials	Providers receive color-coded written screening recommendations and do not receive academic detailing (educational outreach)
Standard materials and academic detailing	Standard support	Providers receive standard written screening recommendations and receive academic detailing (educational outreach)
Color-coded materials and academic detailing	Color-coded materials	Providers receive color-coded written screening recommendations and receive academic detailing (educational outreach)
Standard materials and academic detailing	Academic detailing	Providers receive standard written screening recommendations and receive academic detailing (educational outreach)
Color-coded materials and no academic detailing	No academic detailing	Providers receive color-coded written screening recommendations and do not receive academic detailing (educational outreach)
Color-coded materials and academic detailing	Academic detailing	Providers receive color-coded written screening recommendations and receive academic detailing (educational outreach)
Standard Support Outreach	Standard support	Providers receive standard written screening recommendations and do not receive academic detailing (educational outreach)

Primary Outcome Measures

Name	Time	Method
Effect of educational intervention on providers' recommendations	12 months	Incidence of guidance compliance

Secondary Outcome Measures

Name	Time	Method
Patient compliance	12 months	measured by self- report in surveys to be determined
Patients' belief in the value of screening	12 months	measured by survey to be determined

Trial Locations

Locations (2)

Mount Sinai Beth Israel; 🇺🇸 New York, New York, United States

St. Luke's-Roosevelt; 🇺🇸 New York, New York, United States