Patient Education, Support May Increase CRC Screening

Use of a patient decision aid plus patient navigation increases the rate of colorectal cancer (CRC) screening among vulnerable populations, according to a recent study.

CRC screening is underused, especially among vulnerable populations. Decision aids and patient navigation may improve rates of CRC screening among these populations, but their combined effect on screening rates is unknown.
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In their study, the researchers evaluated 265 patients aged 50 to 75 years from community health centers in North Carolina and New Mexico serving vulnerable populations. Patients were randomly assigned to an intervention group or a control group. Data was collected from January 2014 to March 2016. Patients had an average risk of CRC, spoke English or Spanish, were not current with recommended CRC screening, and were attending primary care visits.

Demographic information indicated that 173 (65%) participants were female, 164 (62%) were Latino; 40 (15%) were white non-Latino; 61 (23%) were black or of mixed race; 191 (78%) had a household income of less than $20,000; 101 (38%) had low literacy; 75 (28%) were on Medicaid; and 91 (34%) were uninsured.

The researchers defined the primary outcome as completion of CRC screening within 6 months of the study baseline visit assessed by blinded medical record review.

Results indicated that 68% of participants in the intervention group completed CRC screening within 6 months, compared with 27% of those in the control group. Additionally, the researchers found that intervention was more effective in women than in men. No effect modification was observed across other subgroups.

“A patient decision aid plus patient navigation increased the rate of CRC screening completion [sic] compared with usual care in [sic] vulnerable primary care patients,” the researchers concluded.

—Christina Vogt

Reference:

Reuland DS, Brenner AT, Hoffman R, et al. Effect of combined patient decision aid and patient navigation vs usual care for colorectal cancer screening in a vulnerable patient population: a randomized clinical trial. JAMA Intern Med. 2017;177(7):967-974. doi:10.1001/jamainternmed.2017.1294.