Cluster randomised controlled trial comparing the effectiveness and cost-effectiveness of two primary care interventions aimed at improving attendance for breast screening

• DOI: 10.1136/jms.8.2.91
• Publication Date: 2002-10-01T19:53:59Z
• Authors: S.H. Richards; C. Bankhead; T.J. Peters; J. Austoker; F.D.R. Hobbs; J. Brown; C. Tydeman; L. Roberts; J. Formby; V. Redman; S. Wilson; D.J. Sharp
• Keywords: Attendance

Objectives To examine the effectiveness and cost-effectiveness of two interventions based in primary care aimed at increasing uptake breast screening. Setting 24 General practices with low second round screening (below 60%) north west London West Midlands, UK. Participants were all women registered these eligible for third round. Methods Pragmatic factorial cluster randomised controlled trial, to a systematic intervention (general practitioner letter), an opportunistic (flag women's notes prompting discussion by health professionals), neither intervention, or both. Outcome measures attendance 6 months after had been screened interventions. Results 6133 Women included: 1721 control; 1818 letter; 1232 flag; 1362 both Attendance data obtained 5732 (93%) women. The independently increased logistic regression model adjusted clustering, flag (odds ratio (OR) 1.43, 95% confidence interval (95% CI) 1.14 1.79; p=0.0019) marginally more effective than letter (OR 1.31, CI 1.05 1.64; p=0.015). Health service costs per additional £26 (letter) £41 (flag). Conclusions Although screening, was cost-effective. Any decision implement rather just will depend on whether (£41) are judged worthwhile terms gains uptake.