The Chest Australia Trial: A randomised controlled trial of an intervention to increase consultation rates in smokers at risk of lung cancer

Emery, JD; Murray, SR; Walter, FM; Martin, A; Goodall, S; Mazza, D; Habgood, E; Kutzer, Y; Barnes, DJ; Murchie, P

The Chest Australia Trial: A randomised controlled trial of an intervention to increase consultation rates in smokers at risk of lung cancer

Emery, JD Murray, SR Walter, FM Martin, A Goodall, S

Mazza, D Habgood, E Kutzer, Y Barnes, DJ Murchie, P

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Publication Type:: Journal Article
Citation:: Thorax, 2019, 74 (4), pp. 362 - 370
Issue Date:: 2019-04-01

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Field	Value	Language
dc.contributor.author	Emery, JD	en_US
dc.contributor.author	Murray, SR	en_US
dc.contributor.author	Walter, FM	en_US
dc.contributor.author	Martin, A	en_US
dc.contributor.author	Goodall, S https://orcid.org/0000-0001-6611-6565	en_US
dc.contributor.author	Mazza, D	en_US
dc.contributor.author	Habgood, E	en_US
dc.contributor.author	Kutzer, Y	en_US
dc.contributor.author	Barnes, DJ	en_US
dc.contributor.author	Murchie, P	en_US
dc.date.available	2018-12-03	en_US
dc.date.issued	2019-04-01	en_US
dc.identifier.citation	Thorax, 2019, 74 (4), pp. 362 - 370	en_US
dc.identifier.issn	0040-6376	en_US
dc.identifier.uri	http://hdl.handle.net/10453/131766
dc.description.abstract	© 2019 Author(s) (or their employer(s)). Background: International research has focused on screening and mass media campaigns to promote earlier patient presentation and detect lung cancer earlier. This trial tested the effect of a behavioural intervention in people at increased risk of lung cancer on help-seeking for respiratory symptoms. Methods: Parallel, individually randomised controlled trial. Eligible participants were long-term smokers with at least 20 pack-years, aged 55 and above. The CHEST intervention entailed a consultation to discuss and implement a self-help manual, followed by self-monitoring reminders to encourage help-seeking for respiratory symptoms. The control group received a brief discussion about lung health. Both groups had baseline spirometry. Telephone randomisation was conducted, 1:1, stratified Medical Research Council (MRC) dyspnoea score and general practice. Participants could not be blinded; data extraction and statistical analyses were performed blinded to group assignment. The primary outcome was respiratory consultation rates. Results: We randomised 551 participants (274 intervention, 277 control) from whom the primary outcome was determined for 542 (269 intervention, 273 control). There was a 40% relative increase in respiratory consultations in the intervention group: (adjusted rates (95% CI) intervention 0.57 (0.47 to 0.70), control 0.41 (0.32 to 0.52), relative rate 1.40 (1.08 to 1.82); p=0.0123). There were no significant differences in time to first respiratory consultation, total consultation rates or measures of psychological harm. The incremental cost-effectiveness ratio was $A1289 per additional respiratory consultation. Conclusions: A behavioural intervention can significantly increase consulting for respiratory symptoms in patients at increased risk of lung cancer. This intervention could have an important role in primary care as part of a broader approach to improve respiratory health in patients at higher risk.	en_US
dc.relation	http://purl.org/au-research/grants/nhmrc/1064121
dc.relation.ispartof	Thorax	en_US
dc.relation.isbasedon	10.1136/thoraxjnl-2018-212506	en_US
dc.subject.classification	Respiratory System	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Lung Neoplasms	en_US
dc.subject.mesh	Respiration Disorders	en_US
dc.subject.mesh	Self Care	en_US
dc.subject.mesh	Smoking	en_US
dc.subject.mesh	Health Behavior	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Primary Health Care	en_US
dc.subject.mesh	Patient Acceptance of Health Care	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Early Detection of Cancer	en_US
dc.subject.mesh	Diagnostic Self Evaluation	en_US
dc.subject.mesh	Smokers	en_US
dc.title	The Chest Australia Trial: A randomised controlled trial of an intervention to increase consultation rates in smokers at risk of lung cancer	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	74	en_US
utslib.for	1112 Oncology and Carcinogenesis	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1103 Clinical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	74	en_US

Abstract:

© 2019 Author(s) (or their employer(s)). Background: International research has focused on screening and mass media campaigns to promote earlier patient presentation and detect lung cancer earlier. This trial tested the effect of a behavioural intervention in people at increased risk of lung cancer on help-seeking for respiratory symptoms. Methods: Parallel, individually randomised controlled trial. Eligible participants were long-term smokers with at least 20 pack-years, aged 55 and above. The CHEST intervention entailed a consultation to discuss and implement a self-help manual, followed by self-monitoring reminders to encourage help-seeking for respiratory symptoms. The control group received a brief discussion about lung health. Both groups had baseline spirometry. Telephone randomisation was conducted, 1:1, stratified Medical Research Council (MRC) dyspnoea score and general practice. Participants could not be blinded; data extraction and statistical analyses were performed blinded to group assignment. The primary outcome was respiratory consultation rates. Results: We randomised 551 participants (274 intervention, 277 control) from whom the primary outcome was determined for 542 (269 intervention, 273 control). There was a 40% relative increase in respiratory consultations in the intervention group: (adjusted rates (95% CI) intervention 0.57 (0.47 to 0.70), control 0.41 (0.32 to 0.52), relative rate 1.40 (1.08 to 1.82); p=0.0123). There were no significant differences in time to first respiratory consultation, total consultation rates or measures of psychological harm. The incremental cost-effectiveness ratio was $A1289 per additional respiratory consultation. Conclusions: A behavioural intervention can significantly increase consulting for respiratory symptoms in patients at increased risk of lung cancer. This intervention could have an important role in primary care as part of a broader approach to improve respiratory health in patients at higher risk.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/131766