title: Can an alert in primary care electronic medical records increase participation in a population-based screening programme for colorectal cancer? COLO-ALERT, a randomised clinical trial.
abstract: BACKGROUND
  Colorectal cancer is an important public health problem in Spain. Over the last decade, several regions have carried out screening programmes, but population participation rates remain below recommended European goals. Reminders on electronic medical records have been identified as a low-cost and high-reach strategy to increase participation. Further knowledge is needed about their effect in a population-based screening programme. The main aim of this study is to evaluate the effectiveness of an electronic reminder to promote the participation in a population-based colorectal cancer screening programme. Secondary aims are to learn population's reasons for refusing to take part in the screening programme and to find out the health professionals' opinion about the official programme implementation and on the new computerised tool.
  
  
  METHODS
  This is a parallel randomised trial with a cross-sectional second stage.
  
  
  METHODS
  all the invited subjects to participate in the public colorectal cancer screening programme that includes men and women aged between 50-69, allocated to the eleven primary care centres of the study and all their health professionals. The randomisation unit will be the primary care physician. The intervention will consist of activating an electronic reminder, in the patient's electronic medical record, in order to promote colorectal cancer screening, during a synchronous medical appointment, throughout the year that the intervention takes place. A comparison of the screening rates will then take place, using the faecal occult blood test of the patients from the control and the intervention groups. We will also take a questionnaire to know the opinions of the health professionals. The main outcome is the screening status at the end of the study. Data will be analysed with an intention-to-treat approach.
  
  
  CONCLUSIONS
  We expect that the introduction of specific reminders in electronic medical records, as a tool to facilitate and encourage direct referral by physicians and nurse practitioners to perform colorectal cancer screening will mean an increase in participation of the target population. The introduction of this new software tool will have good acceptance and increase compliance with recommendations from health professionals.
  
  
  BACKGROUND
  Clinical Trials.gov identifier NCT01877018.
authors.affiliation: Primary Healthcare Centre Santa Rosa, Catalan Health Institute, Carrer El Cano s/n, 08921 Santa Coloma de Gramenet, Spain. cguiriguet.bnm.ics@gencat.cat.
authors.forename: Carolina
authors.initials: C
authors.lastname: Guiriguet-Capdevila
authors.forename: Laura
authors.initials: L
authors.lastname: Muñoz-Ortiz
authors.forename: Irene
authors.initials: I
authors.lastname: Rivero-Franco
authors.forename: Carme
authors.initials: C
authors.lastname: Vela-Vallespín
authors.forename: Mercedes
authors.initials: M
authors.lastname: Vilarrubí-Estrella
authors.forename: Miquel
authors.initials: M
authors.lastname: Torres-Salinas
authors.forename: Jaume
authors.initials: J
authors.lastname: Grau-Cano
authors.forename: Andrea
authors.initials: A
authors.lastname: Burón-Pust
authors.forename: Cristina
authors.initials: C
authors.lastname: Hernández-Rodríguez
authors.forename: Antonio
authors.initials: A
authors.lastname: Fuentes-Peláez
authors.forename: Dolores
authors.initials: D
authors.lastname: Reina-Rodríguez
authors.forename: Rosa
authors.initials: R
authors.lastname: De León-Gallo
authors.forename: Leonardo
authors.initials: L
authors.lastname: Mendez-Boo
authors.forename: Pere
authors.initials: P
authors.lastname: Torán-Monserrat
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000191:economics; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D050316:Medical Order Entry Systems; D008875:Middle Aged; D009780:Occult Blood; D058007:Physicians, Primary Care; D013030:Spain