The study, published in JAMA Internal Medicine, was conducted by Sameer D. Saini, MD, MS, and colleagues from the VA Ann Arbor Healthcare System and Michigan Medicine.
Key Points:
- The study involved 431 older, average-risk adults at two U.S. Department of Veterans Affairs facilities, with a mean age of 71.5 years and 98.4% being men.
- Participants in the intervention group received detailed, personalized information about CRC screening benefits and harms, tailored to their age, sex, screening history, and comorbidities. The control group received general screening information.
- The primary outcome measured was whether CRC screening was ordered within 2 weeks of a primary care visit.
Findings:
- There was no significant difference in screening orders between the intervention and control groups overall.
- However, in the lowest benefit quartile, the intervention group had fewer screening orders compared to the control group, and in the highest benefit quartile, the intervention group had more screening orders.
- At 6 months, a lower percentage of the intervention group had undergone screening compared to the control group.
Conclusion:
- Providing older adults with detailed, personalized information about CRC screening benefits and harms before a primary care visit led to more screening orders aligned with the benefit and reduced overall screening utilization.
- The study suggests that a multilevel intervention, including personalized information, clinician education, and system-level support, can better align screening orders with screening benefits and decrease overall screening usage.