T J Wilt1, J Paul, M Murdoch, D Nelson, S Nugent, H B Rubins. 1. Minneapolis VA Center for Chronic Disease Outcomes Research, University of Minnesota Department of Medicine, Minneapolis, Minn., USA. Tim.wilt@med.va.gov
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.
RCT Entities:
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.
Authors: Melissa R Partin; David Nelson; Ann Barry Flood; Greta Friedemann-Sánchez; Timothy J Wilt Journal: Health Expect Date: 2006-09 Impact factor: 3.377
Authors: Ronald E Myers; Constantine Daskalakis; James Cocroft; Elisabeth J S Kunkel; Ernestine Delmoor; Matthew Liberatore; Robert L Nydick; Earl R Brown; Roy N Gay; Thomas Powell; Roberta Lee Powell Journal: J Natl Med Assoc Date: 2005-08 Impact factor: 1.798
Authors: Melissa R Partin; David Nelson; David Radosevich; Sean Nugent; Ann B Flood; Nancy Dillon; Jeremy Holtzman; Michele Haas; Timothy J Wilt Journal: J Gen Intern Med Date: 2004-08 Impact factor: 5.128
Authors: Caroline S Dorfman; Randi M Williams; Elisabeth C Kassan; Sara N Red; David L Dawson; William Tuong; Elizabeth R Parker; Janet Ohene-Frempong; Kimberly M Davis; Alexander H Krist; Steven H Woolf; Marc D Schwartz; Mary B Fishman; Carmella Cole; Kathryn L Taylor Journal: BMC Med Inform Decis Mak Date: 2010-03-03 Impact factor: 2.796
Authors: Randi M Williams; Kimberly M Davis; George Luta; Sara N Edmond; Caroline S Dorfman; Marc D Schwartz; John Lynch; Chiledum Ahaghotu; Kathryn L Taylor Journal: Patient Educ Couns Date: 2013-01-26
Authors: Kathryn L Taylor; Randi M Williams; Kimberly Davis; George Luta; Sofiya Penek; Samantha Barry; Scott Kelly; Catherine Tomko; Marc Schwartz; Alexander H Krist; Steven H Woolf; Mary B Fishman; Carmella Cole; Edward Miller Journal: JAMA Intern Med Date: 2013-10-14 Impact factor: 21.873
Authors: J Austoker; C Bankhead; L J L Forbes; L Atkins; F Martin; K Robb; J Wardle; A J Ramirez Journal: Br J Cancer Date: 2009-12-03 Impact factor: 7.640