A randomised trial of weekend and evening breast screening appointments

Autor: Dharmishta Parmar, Stephen W. Duffy, Judith Offman, Julietta Patnick, S Marriage, B Eckersley, E Kutt, M Lamont, Sue Hudson, J Smith, Hanna Birke, Mary Wilson, F Dungey, A Hartley, Y Loughrey
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Zdroj: British Journal of Cancer
ISSN: 1532-1827
0007-0920
Popis: Although there is disagreement about the absolute size of the mortality reduction, it is generally accepted that mammography prevents deaths from breast cancer (Independent UK Panel on Breast Cancer Screening, 2012). The UK National Health Service (NHS) offers 3-year, two-view mammography to all women aged 50–70 years, which is currently being expanded to women aged 47–73 years in England. Although it must be accepted that a proportion of those offered screening will make an informed decision not to take up the offer, the provider of the service has a responsibility to ensure as far as possible that the decision is not unduly swayed by issues of convenience. Enhancing the accessibility of the programme is therefore desirable to improve the efficiency, effectiveness, and equity of the service. Attendance in the UK NHS Breast Screening Programme exceeds 70% on average (NHS Cancer Screening Programmes, 2011). There are areas with considerably lower attendance rates though, and recent declines have been observed. Non-attendance for breast screening has been associated with various factors in United Kingdom and elsewhere, notably low socioeconomic status, specific health attitudes and beliefs, and distance from place of residence to the screening site (Maheswaran et al, 2006; Paskett et al, 2006; Rutter et al, 2006). Although one study in Spain found inconvenience of the appointment time as a reason for non-attendance (Alcaraz et al, 2002), the relationship of appointment time with attendance is not well researched. Preliminary surveys of American women found that women who worked felt that evening and weekend screening appointments would be useful (Engelman et al, 2005). This was mirrored in a previous survey of women in New Zealand, where 17% felt that offering out-of-hours appointments would increase attendance (Richardson, 1990). In contrast, a study in the 1990s suggested that offering appointments outside of working hours did not materially alter attendance rates (Readman and Asbury, 1999). However, with female employment rates higher now than in the past, the subject is worth revisiting. It is furthermore not clear whether the offer of an evening appointment would, for example, be more welcome in summer than winter, or whether women would be happier attending an evening appointment in a hospital than in a mobile unit. In addition, location of a screening unit could have an impact on attendance of out-of-hours clinics, for example, a more centrally located screening unit might be more attractive on a Saturday, as the screening appointment could be combined with a shopping trip. We carried out a randomised controlled study of offering appointments after working hours during the week and at weekends, with the aim to discover whether the offer of these out-of-hours screening appointments would increase attendance rates. To determine the optimum strategy for offering out-of-hours appointments, subgroup analysis was carried out to ascertain whether this effect is modified by prevalent or incident status, static or mobile screening sites, age of invitee, and time of year of appointment.
Databáze: OpenAIRE
Externí odkaz: