Implementation of a mailed faecal immunochemical test programme for colorectal cancer screening among Veterans.

Autor:	Deeds SA; Department of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA stefanie.deeds@va.gov.; Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, Washington, USA., Moore CB; Sierra Pacific Network, US Department of Veterans Affairs, Pleasant Hill, California, USA., Gunnink EJ; Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, Washington, USA., Wheat CL; Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, Washington, USA., Robinson AE; Sierra Pacific Network, US Department of Veterans Affairs, Pleasant Hill, California, USA., Bomsztyk MD; Sierra Pacific Network, US Department of Veterans Affairs, Pleasant Hill, California, USA.; Department of Medicine, University of California San Francisco, San Francisco, California, USA., Geyer JR; Department of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA.; Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, Washington, USA., Chen A; Department of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA.; Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, Washington, USA., Godbout RM; Sierra Pacific Network, US Department of Veterans Affairs, Pleasant Hill, California, USA.; Department of Internal Medicine, University of California Davis, Davis, California, USA., Nelson KM; Department of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA.; Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, Washington, USA., Dominitz JA; Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, Washington, USA.; National Gastroenterology and Hepatology Program, US Department of Veterans Affairs, Seattle, Washington, USA.; Department of Medicine, Division of Gastroenterology, University of Washington, Seattle, Washington, USA., Reddy A; Department of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA.; Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, Washington, USA.; Department of Health Services, Univeristy of Washington, Seattle, Washington, USA.
Jazyk:	angličtina
Zdroj:	BMJ open quality [BMJ Open Qual] 2022 Nov; Vol. 11 (4).
DOI:	10.1136/bmjoq-2022-001927
Abstrakt:	Background: Screening for colorectal cancer (CRC) with faecal immunochemical test (FIT) is effective at reducing CRC mortality. Unfortunately, the COVID-19 pandemic has been associated with deferred care, especially screening for CRC. Aim: We sought to develop a mailed FIT programme (MFP) to increase CRC screening and make recommendations for adoption across the Veterans Health Administration (VHA) and for other large healthcare systems. Setting: 2 regional VA medical centres in California and Washington state. Participants: 5667 average risk veterans aged 50-75 overdue or due within 90 days for CRC screening. Programme Description: A multidisciplinary implementation team collaborated to mail an FIT kit to eligible veterans. Both sites mailed a primer postcard, and one site added an automated reminder call. Programme Evaluation: We monitored FIT return and positivity rate, as well as impact of the programme on clinical staff. 34% of FIT kits were returned within 90 days and 7.8% were abnormal. Discussion: We successfully implemented a population-based MFP at multiple regional VA sites and recommend that these efforts be spread across VA. Our model of regional leadership, facility champions and using centralised resources can be adaptable to other large healthcare systems. MFPs support catch-up from disrupted care by addressing access to CRC screening, unburden primary care visits and conserve limited procedural resources. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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