gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

New strategies needed to improve implementation of familial colorectal cancer guidelines

Meeting Abstract

  • N. Dekker - Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  • R. Hermens - Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  • G. Elwyn - Cardiff University, Cardiff, United Kingdom
  • F. Nagengast - Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  • H. de Wilt - Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  • H. van Krieken - Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  • M. Ligtenberg - Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  • T. van der Weijden - Maastricht University, Maastricht, The Netherlands
  • W. van Zelst-Stams - Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  • N. Hoogerbrugge - Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocO25

DOI: 10.3205/12gin057, URN: urn:nbn:de:0183-12gin0571

Veröffentlicht: 10. Juli 2012

© 2012 Dekker et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Currently, only 12–49% of individuals with an increased familial colorectal cancer (CRC) risk are referred for effective cancer prevention.

Objectives: To improve referral rates for genetic counselling and surveillance colonoscopies for high-risk and moderate-risk families, respectively.

Methods: Eighteen hospitals participated in a clustered RCT. Nine intervention hospitals received a website and brochures about familial CRC risk for patients and clinicians, and education and guideline pocket cards for clinicians. Patients in nine control hospitals received usual care. Data were collected from patients and clinicians using questionnaires and medical records.

Results: Fifty-five percent of patients (n=478/862) and 34% of clinicians (n=47/137) participated. In the intervention group, 110/161 patients (68%) and 7/20 clinicians (35%) visited the website; 34/161 patients (21%) read the brochure. Patients valued clinicians' information as most useful. Clinicians rated the education and guideline pocket cards as most useful. In the intervention group, 1/10 high-risk patients (10%) was referred for genetic counselling, versus 5/34 (15%) in the control group (p=.705). In the intervention group, relatives of 6/21 (29%) moderate-risk patients had received surveillance colonoscopies, versus 23/43 (53%) in the control group (p=.065).

Discussion: Implementation of tailored digital and printed information did not improve referral rates for genetic counselling or surveillance colonoscopies of individuals at an increased familial CRC risk. Although patients and clinicians appreciated the materials, patients preferred clinicians' advice regarding their familial risk; clinicians preferred more traditional materials.

Implications for guideline developers/users: New strategies aimed both at patients and clinicians are needed to improve familial colorectal cancer prevention.