对男性进行前列腺癌筛查教育。一份邮寄宣传册的随机试验。

Educating men about prostate cancer screening. A randomized trial of a mailed pamphlet.

作者信息

Wilt T J, Paul J, Murdoch M, Nelson D, Nugent S, Rubins H B

机构信息

Minneapolis VA Center for Chronic Disease Outcomes Research, University of Minnesota Department of Medicine, Minneapolis, Minn., USA.

出版信息

Eff Clin Pract. 2001 May-Jun;4(3):112-20.

PMID:11434074

Abstract

CONTEXT

Although evidence-based guidelines recommend that physicians inform men about prostate cancer screening, the most efficient way to do this is not known.

OBJECTIVE

To evaluate whether a mailed educational pamphlet affected men's knowledge about early detection of prostate cancer.

DESIGN

Randomized, controlled trial.

SETTING

Primary care clinic of the Minneapolis VA Medical Center.

PATIENTS

342 men at least 50 years of age who responded to a mailed survey (overall response rate, 68%) and did not report a history of prostate cancer.

INTERVENTION

"Early Prostate Cancer" pamphlet mailed to patients in the intervention group 1 week before their scheduled clinic appointments.

OUTCOME MEASURES

Patients' responses to a survey mailed 1 week after their clinic appointments; prostate-specific antigen (PSA) testing determined from electronic medical records.

RESULTS

Respondents were predominantly elderly white men (mean age, 71 years; 90% white) with chronic illnesses (48% described their health as "fair" or "poor"). Men who received the educational pamphlet were better informed than men in the usual care group, as measured by correct responses to the following three questions about prostate cancer screening: the natural history of prostate cancer (32% vs. 24%; P = 0.10), whether treatment lengthens lives of men with early prostate cancer (56% vs. 44%; P = 0.04), and accuracy of PSA testing (46% vs. 27%; P < 0.008). The overall proportion of correctly answered questions was greater in the intervention group (45% vs. 32%; P < 0.001). Testing for PSA in the year after the index clinic appointments did not differ significantly between the intervention group and the usual care group (31% vs. 37%; P > 0.2).

CONCLUSIONS

Male veterans are poorly informed about the potential benefits and risks of prostate cancer screening. Although our mailed educational pamphlet enhanced knowledge only modestly, it was an inexpensive and easily implemented intervention.

摘要

背景

尽管循证指南建议医生告知男性进行前列腺癌筛查，但最有效的告知方式尚不清楚。

目的

评估邮寄的教育手册是否会影响男性对前列腺癌早期检测的了解。

设计

随机对照试验。

地点

明尼阿波利斯退伍军人医疗中心的初级保健诊所。

患者

342名年龄至少50岁的男性，他们回复了邮寄的调查问卷（总体回复率为68%），且未报告有前列腺癌病史。

干预措施

在干预组患者预定的门诊预约前1周，将“早期前列腺癌”手册邮寄给他们。

观察指标

患者在门诊预约1周后对邮寄调查问卷的回复；从电子病历中确定前列腺特异性抗原（PSA）检测情况。

结果

受访者主要是老年白人男性（平均年龄71岁；90%为白人），患有慢性疾病（48%将自己的健康状况描述为“一般”或“较差”）。通过对以下三个关于前列腺癌筛查问题的正确回答来衡量，收到教育手册的男性比常规护理组的男性了解得更多：前列腺癌的自然病程（32%对24%；P = 0.10）、治疗是否能延长早期前列腺癌男性的寿命（56%对44%；P = 0.04）以及PSA检测的准确性（46%对27%；P < 0.008）。干预组正确回答问题的总体比例更高（45%对32%；P < 0.001）。在首次门诊预约后的一年中，干预组和常规护理组的PSA检测率没有显著差异（31%对37%；P > 0.2）。