Results from the BETTER WISE trial: a pragmatic cluster two arm parallel randomized controlled trial for primary prevention and screening in primary care during the COVID-19 pandemic
BACKGROUND: Cancer and chronic diseases are a major cost to the healthcare system and multidisciplinary models with access to prevention and screening resources have demonstrated improvements in chronic disease management and prevention. Research demonstrated that a trained Prevention Practitioner (...
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BioMed Central
2023
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Online Access: | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10537846/ https://doi.org/10.1186/s12875-023-02159-6 |
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Research Manca, Donna Patricia Fernandes, Carolina Lofters, Aisha Aubrey-Bassler, Kris Shea-Budgell, Melissa Campbell-Scherer, Denise Sopcak, Nicolette Meaney, Christopher Moineddin, Rahim McBrien, Kerry Krueger, Paul Wong, Tracy Grunfeld, Eva Results from the BETTER WISE trial: a pragmatic cluster two arm parallel randomized controlled trial for primary prevention and screening in primary care during the COVID-19 pandemic |
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Research |
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BACKGROUND: Cancer and chronic diseases are a major cost to the healthcare system and multidisciplinary models with access to prevention and screening resources have demonstrated improvements in chronic disease management and prevention. Research demonstrated that a trained Prevention Practitioner (PP) in multidisciplinary team settings can improve achievement of patient level prevention and screening actions seven months after the intervention. METHODS: We tested the effectiveness of the PP intervention in a pragmatic two-arm cluster randomized controlled trial. Patients aged 40–65 were randomized at the physician level to an intervention group or to a wait-list control group. The intervention consisted of a patient visit with a PP. The PP received training in prevention and screening and use of the BETTER WISE tool kit. The effectiveness of the intervention was assessed using a composite outcome of the proportion of the eligible prevention and screening actions achieved between intervention and control groups at 12-months. RESULTS: Fifty-nine physicians were recruited in Alberta, Ontario, and Newfoundland and Labrador. Of the 1,005 patients enrolled, 733 (72.9%) completed the 12-month analysis. The COVID-19 pandemic occurred during the study time frame at which time nonessential prevention and screening services were not available and in-person visits with the PP were not allowed. Many patients and sites did not receive the intervention as planned. The mean composite score was not significantly higher in patients receiving the PP intervention as compared to the control group. To understand the impact of COVID on the project, we also considered a subset of patients who had received the intervention and who attended the 12-month follow-up visit before COVID-19. This assessment demonstrated the effectiveness of the BETTER visits, similar to the findings in previous BETTER studies. CONCLUSIONS: We did not observe an improvement in cancer and chronic disease prevention and screening (CCDPS) outcomes at 12 months ... |
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Text |
author |
Manca, Donna Patricia Fernandes, Carolina Lofters, Aisha Aubrey-Bassler, Kris Shea-Budgell, Melissa Campbell-Scherer, Denise Sopcak, Nicolette Meaney, Christopher Moineddin, Rahim McBrien, Kerry Krueger, Paul Wong, Tracy Grunfeld, Eva |
author_facet |
Manca, Donna Patricia Fernandes, Carolina Lofters, Aisha Aubrey-Bassler, Kris Shea-Budgell, Melissa Campbell-Scherer, Denise Sopcak, Nicolette Meaney, Christopher Moineddin, Rahim McBrien, Kerry Krueger, Paul Wong, Tracy Grunfeld, Eva |
author_sort |
Manca, Donna Patricia |
title |
Results from the BETTER WISE trial: a pragmatic cluster two arm parallel randomized controlled trial for primary prevention and screening in primary care during the COVID-19 pandemic |
title_short |
Results from the BETTER WISE trial: a pragmatic cluster two arm parallel randomized controlled trial for primary prevention and screening in primary care during the COVID-19 pandemic |
title_full |
Results from the BETTER WISE trial: a pragmatic cluster two arm parallel randomized controlled trial for primary prevention and screening in primary care during the COVID-19 pandemic |
title_fullStr |
Results from the BETTER WISE trial: a pragmatic cluster two arm parallel randomized controlled trial for primary prevention and screening in primary care during the COVID-19 pandemic |
title_full_unstemmed |
Results from the BETTER WISE trial: a pragmatic cluster two arm parallel randomized controlled trial for primary prevention and screening in primary care during the COVID-19 pandemic |
title_sort |
results from the better wise trial: a pragmatic cluster two arm parallel randomized controlled trial for primary prevention and screening in primary care during the covid-19 pandemic |
publisher |
BioMed Central |
publishDate |
2023 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10537846/ https://doi.org/10.1186/s12875-023-02159-6 |
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Newfoundland |
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Newfoundland |
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BMC Prim Care |
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10537846/ http://dx.doi.org/10.1186/s12875-023-02159-6 |
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© BioMed Central Ltd., part of Springer Nature 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
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https://doi.org/10.1186/s12875-023-02159-6 |
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BMC Primary Care |
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24 |
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ftpubmed:oai:pubmedcentral.nih.gov:10537846 2023-10-29T02:38:01+01:00 Results from the BETTER WISE trial: a pragmatic cluster two arm parallel randomized controlled trial for primary prevention and screening in primary care during the COVID-19 pandemic Manca, Donna Patricia Fernandes, Carolina Lofters, Aisha Aubrey-Bassler, Kris Shea-Budgell, Melissa Campbell-Scherer, Denise Sopcak, Nicolette Meaney, Christopher Moineddin, Rahim McBrien, Kerry Krueger, Paul Wong, Tracy Grunfeld, Eva 2023-09-28 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10537846/ https://doi.org/10.1186/s12875-023-02159-6 en eng BioMed Central http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10537846/ http://dx.doi.org/10.1186/s12875-023-02159-6 © BioMed Central Ltd., part of Springer Nature 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. BMC Prim Care Research Text 2023 ftpubmed https://doi.org/10.1186/s12875-023-02159-6 2023-10-01T01:26:04Z BACKGROUND: Cancer and chronic diseases are a major cost to the healthcare system and multidisciplinary models with access to prevention and screening resources have demonstrated improvements in chronic disease management and prevention. Research demonstrated that a trained Prevention Practitioner (PP) in multidisciplinary team settings can improve achievement of patient level prevention and screening actions seven months after the intervention. METHODS: We tested the effectiveness of the PP intervention in a pragmatic two-arm cluster randomized controlled trial. Patients aged 40–65 were randomized at the physician level to an intervention group or to a wait-list control group. The intervention consisted of a patient visit with a PP. The PP received training in prevention and screening and use of the BETTER WISE tool kit. The effectiveness of the intervention was assessed using a composite outcome of the proportion of the eligible prevention and screening actions achieved between intervention and control groups at 12-months. RESULTS: Fifty-nine physicians were recruited in Alberta, Ontario, and Newfoundland and Labrador. Of the 1,005 patients enrolled, 733 (72.9%) completed the 12-month analysis. The COVID-19 pandemic occurred during the study time frame at which time nonessential prevention and screening services were not available and in-person visits with the PP were not allowed. Many patients and sites did not receive the intervention as planned. The mean composite score was not significantly higher in patients receiving the PP intervention as compared to the control group. To understand the impact of COVID on the project, we also considered a subset of patients who had received the intervention and who attended the 12-month follow-up visit before COVID-19. This assessment demonstrated the effectiveness of the BETTER visits, similar to the findings in previous BETTER studies. CONCLUSIONS: We did not observe an improvement in cancer and chronic disease prevention and screening (CCDPS) outcomes at 12 months ... Text Newfoundland PubMed Central (PMC) BMC Primary Care 24 1 |