Facele study

Isabelle Auger, Amélie Aïm-Eusébi, Josselin Le Bel, Tristan Delory, Julie Etcheberry, Alain Mercier

Keywords: colorectal cancer shared decision

Background:

Screening for colorectal cancer (CRC) among patients at average risk is based in France on a fecal occult blood test (FOBT), carried out every 2 years from 50 to 74. If the FOBT is positive, a colonoscopy should be performed. Participation in the CRC screening program has been declining since 2016-2017. It’s implementation has to get through many obstacles, either on the side of doctors/general practitioners (GP) and/or on the side of patients. GPs have to adapt their communication to the patient’s literacy in order to explain the test, and lead the patient to choose the decision which suits him. To reach a shared decision, GPs should adopt a person-centered approach taking into account the patient’s perspectives

Research questions:

How a face-to-face training of CRC screening using a patient-centered approach by the GP, influence a shared decision in the context?.

Method:

A cluster randomized trial and qualitative approach will be performed. The primary aim will assess the superiority of a presential training of GPs in a patient-centered approach, compared to current practice, on the implementation of a shared decision. We’ll use the shared patient decision-making self-questionnaire (SDM-Q9), validated in French. We will compare the mean of the SDM-Q9 between each arm of the trial. The self-administered questionnaire will be given to the patient by the GP immediately after a consultation while a FOBT will be delivered.
The Secondary objectives will
- Evaluate the effect of the training on the GPs’ rate of CRC screening, 6 months after inclusion
- Assess patients’ decisional conflict with the SURE test
- Explore the understanding of the shared decision-making process among GP and patients with a qualitative study

Results:

Conclusions:

This study should give us a better understanding of the decision making process in the context of CRC screening and makes patient more active in the decision

Points for discussion: