Can a Complex Intervention Targeted at the Community and at Health Care Providers Reduce the Total Diagnostic Interval for Common Cancers in Rural WA? (#336)
Introduction: Rural cancer patients in Australia have significantly poorer outcomes than metropolitan counterparts and this may be partly due to later stage at diagnosis and poor access to treatments. We report a trial of a complex intervention aimed at reducing the time to diagnosis for cancer patients in rural Western Australia (WA) which is in the evaluation phase. This project commenced in 2009 in partnership with UWA, Cancer Council WA and Department of Health WA.
Methods: A 2x2 factorial cluster randomised trial of: 1. A community symptom awareness campaign; 2. A general practice based intervention aimed at implementing cancer risk models and best practice referral routes. Two matched geographical areas of rural WA were randomised to the community intervention or control region. The campaign applies both community engagement and regional media messages to promote earlier help-seeking for specific cancer-related symptoms. General practices within both geographical regions have been randomised to receive multiple academic detailing visits or no intervention. The primary outcome measure is the total diagnostic interval from first symptom to date of diagnosis. Additional measures will include TNM stage, measures of campaign coverage and impact, and health economic outcomes. Results: At 16 months recruitment of people with breast, lung, bowel or prostate cancer to the trial had already exceeded target accrual of 850 people over two years.
Results of the preliminary evaluation for the community campaign via Computer Assisted Telephone Survey and of the GP education program will be presented.
Conclusion: This is the largest trial we know of to date to test this type of intervention in a RCT and its results will have significant transferability both nationally and internationally. The trial will report its main findings in 2015.