提醒策略对癌症筛查依从性的影响：一项随机对照试验。
Effectiveness of reminder strategies on cancer screening adherence: a randomised controlled trial.
机构信息
Institute of Digestive Disease, and the Jockey Club School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong.
Institute of Digestive Disease, Faculty of Medicine, the Chinese University of Hong Kong.
出版信息
Br J Gen Pract. 2018 Sep;68(674):e604-e611. doi: 10.3399/bjgp18X698369. Epub 2018 Aug 13.
BACKGROUND
Few randomised controlled trials (RCTs) have evaluated the different recalling approaches for enhancing adherence to faecal immunochemical test (FIT)-based screening.
AIM
The authors evaluated the effectiveness of two telecommunication strategies on improving adherence to yearly FIT screening.
DESIGN AND SETTING
A randomised, parallel group trial was performed in a primary care screening practice.
METHOD
The authors recruited 629 asymptomatic individuals aged 40-70 years with a negative FIT in 2015 to a population-based screening programme. On participation, they were invited to repeat their second round of FIT in 2016, 12 months after the first test. Each participant was randomly assigned to either interactive telephone reminder ( = 207), short message service reminder (SMS, = 212), or control, where no additional interventions were delivered after the findings of their first FIT was communicated to the participants ( = 210). Reminders in the intervention groups were delivered 1 month before subjects' expected return. Additional telephone reminders were delivered 2 months after the expected return date to all subjects who defaulted specimen return. The outcomes included rates of FIT collection and specimen return up to 6 months after their expected return.
RESULTS
At 6 months, the cumulative FIT collection rate was 95.1%, 90.4%, and 86.5%, respectively, for the telephone, SMS, and control groups ( = 0.010). The corresponding specimen return rate was 94.1%, 90.0%, and 86.0% ( = 0.022). When compared with the control, only subjects in the telephone group were significantly more likely to collect FIT tubes (adjusted odds ratio [AOR] 3.18, 95% confidence interval [CI] = 1.50 to 6.75, = 0.003) and return completed specimens (AOR = 2.73, 95% CI = 1.35 to 5.53, = 0.005).
CONCLUSION
Interactive telephone reminders are effective at securing previously screened subjects to repeat screening 1 year after a negative finding.
背景
很少有随机对照试验（RCT）评估过不同的回忆方法对提高粪便免疫化学试验（FIT）筛查的依从性的作用。
目的
作者评估了两种远程通信策略对提高年度 FIT 筛查依从性的有效性。
设计和设置
在一个初级保健筛查诊所进行了一项随机、平行组试验。
方法
作者招募了 629 名年龄在 40-70 岁之间的无症状个体，这些个体在 2015 年进行了基于人群的筛查计划，FIT 结果为阴性。在参与时，他们被邀请在第一次测试后 12 个月即 2016 年再次进行第二轮 FIT。每位参与者被随机分配到互动电话提醒组（n = 207）、短信服务提醒组（SMS，n = 212）或对照组（n = 210），对照组在将参与者的第一次 FIT 结果通知给他们后不进行任何额外的干预。干预组的提醒在参与者预期返回前 1 个月发送。如果所有未按时返回标本的参与者都默认，将在预期返回日期后 2 个月再次进行额外的电话提醒。结果包括预期返回后 6 个月内 FIT 采集和标本返回的比率。
结果
在 6 个月时，电话组、短信组和对照组的 FIT 采集累积率分别为 95.1%、90.4%和 86.5%（= 0.010）。相应的标本返回率分别为 94.1%、90.0%和 86.0%（= 0.022）。与对照组相比，只有电话组的受试者更有可能采集 FIT 管（调整后的优势比 [AOR] 3.18，95%置信区间 [CI] = 1.50 至 6.75，= 0.003）和返回已完成的标本（AOR = 2.73，95%CI = 1.35 至 5.53，= 0.005）。
结论
互动电话提醒可有效地促使先前接受过筛查的受试者在阴性结果后 1 年再次进行筛查。
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