An Observational Study of GP Verbal Reminders Upon Cervical Screening

Study Overview
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Brief Summary
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Cervical cancer screening is offered to all women in the United Kingdom (UK) between the ages of 24.5 and 64 years of age. The majority of screening is performed in primary care and the rate remains stubbornly below 80%, despite an automated national invitation system. This study is designed to assess the effectiveness of a physician invitation during a telephone or face-to-face primary care appointment upon non responders of automated invitations, to increase the uptake of cervical screening.

Detailed Description
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It is estimated that between 800 and 2,000 deaths a year are now prevented due to the effectiveness of the UK's national cervical screening programme and mortality rates have dropped by over 75% since the 1970s. These statistics corroborate the importance of the screening programme in reducing mortality from cervical cancer. Cervical screening rates in the UK remains stubbornly below 80% and interventions are needed to attract the 20% who are missing out on screening. This prospective observational study is designed to measure the impact of a physician intervention in a usual healthcare environment, amongst a heterogeneous patient population to yield replicable real-world results. The intervention arm will receive a physician intervention to inform them of their overdue screening status, remind them of the importance of cervical screening and guide them to book a screening appointment. The screening rate in the intervention arm will be compared to a control made up of patients seen by other clinicians and receiving unstructured reminders. The results will assist physicians in deciding whether a structured intervention is anymore effective than the unstructured advice currently given at improving screening rates in the non responder population.

Official Title
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Three-year Prospective Cohort Study of the Effectiveness of Physician Reminders on Cervical Screening Uptake Amongst Non Responders in a UK Primary Care Setting

Conditions
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HPV-Related Cervical Carcinoma, Physician-Patient Relations

Intervention / Treatment
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* Behavioral: Cervical Screening Reminder


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Registered patient with a cervix Non responder to cervical screening invitation Exclusion Criteria: Incorrectly reminded i. Coding errors ii. Human error Temporary patients i. Did not remain registered for minimum of 6 months following intervention Screening refusal Inappropriate to include i. Terminal illness ii. Prolonged hospitalisation iii. Death due to non-cervical cancer attributable cause

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Intervention<br>The principal investigator reviews the medical notes of all individuals they consult over a period of three years to check if they are non responders. If confirmed as non responder, they receive a three-step verbal intervention: Your cervical cancer screening is now overdue. The test is easy to perform and saves thousands of lives from cervical cancer every year. Should we book an appointment for cervical screening now so that you make sure you have it done? Those who are seen face-to-face receive a fourth intervention: An appointment slip is given to the patient to hand to the receptionist. This includes the patient's name and the comment, book an appointment with practice nurse for cervical screening. | Behavioral: Cervical Screening Reminder<br>* Verbal reminder and if seen face-to-face, a written appointment booking slip.<br>|
| Control<br>The control group receives standard unstructured reminders regarding their overdue status from any of the 6 other clinicians during appointments and / or reminder letters from the administration team. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Uptake of Cervical Screening | The number of patients who undergo cervical screening | Up to 1 year post intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to book screening | Length of time taken to undergo screening following intervention | Up to 1 year post intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cervical Screening, Primary health care, Physician intervention