DOI: 10.5061/dryad.g1jwstqq2
title: Clinicians’ opinions on recommending aspirin to prevent colorectal cancer to Australians aged 50 to 70 years: A qualitative study

description: Objectives Australian guidelines recommend all 50 to 70-year-olds without
 existing contraindications consider taking low-dose aspirin (100 mg – 300
 mg per day) for at least 2.5 years to reduce their risk of developing
 colorectal cancer. We aimed to explore clinicians’, practices, knowledge,
 opinions, and barriers and facilitators to the implementation of these new
 guidelines. Methods Semi-structured interviews were conducted with
 clinicians to whom the new guidelines may be applicable (familial cancer
 clinic staff (geneticists, oncologists and genetic counsellors),
 gastroenterologists, pharmacists, and general practitioners (GPs)). The
 Consolidated Framework for Implementation Research (CFIR) underpinned the
 development of the interview guide. Coding was inductive and themes were
 developed through consensus between the authors. Emerging themes were
 mapped onto the CFIR domains: characteristics of the intervention, outer
 setting, inner setting, individual characteristics and process. Results
 Sixty-four interviews were completed between March and October 2019.
 Aspirin was viewed as a safe and cheap option for cancer prevention. GPs
 were considered by all clinicians as the most important health
 professionals for implementation of the guidelines. Cancer Council
 Australia, as a trusted organisation, was an important facilitator to
 guideline adoption. Uncertainty about aspirin dosage and perceived
 strength of the evidence, the precise wording of the recommendation,
 previous changes to guidelines about aspirin, and conflicting findings
 from trials in older populations were barriers to implementation.
 Conclusion Widespread adoption of these new guidelines could be an
 important strategy to reduce the incidence of bowel cancer, but this will
 require more active implementation strategies focused on primary care and
 the wider community.
description: Qualitative transcript data
 were managed using NVivo 12. The interviews for each type of participant;
 FCC staff, GPs, gastroenterologists and pharmacists were initially
 analysed separately. Complete coding of each interview was conducted by
 the author who interviewed the participant where everything that was
 spoken by the participants was organised into specific topics. At the
 first level of coding, codes were produced inductively for each of the
 participant professional groups upon completion. For enhanced interpretive
 rigour, several interviews in each participant group were co-coded by
 another researcher and progressively checked in regular researcher
 meetings. The coding for several interviews per participant type was
 checked by a second researcher.<sup> </sup> After first-level coding, codes
 were grouped into themes. Thematic analysis was employed at this level
 where themes emerged from the first-level coding through discussions
 between the researchers. About 20 themes per professional group type were
 defined. Themes from each professional group type were discussed between
 the researchers and brought together if they could be. Themes were then
 mapped onto the domain and constructs from the CFIR: characteristics of
 intervention, outer setting, inner setting, characteristics of
 individuals, and process.
description: This is a qualitative dataset.