Comparative effectiveness of two pharmacy-based colorectal cancer screening interventions during an annual influenza vaccination campaign.

OBJECTIVE To compare the effectiveness of two different pharmacy-based colorectal cancer screening (CRCS) interventions taking place during an annual influenza vaccination campaign. DESIGN Time-randomized clinical trial. SETTING San Francisco, CA, in late 2008. PARTICIPANTS 133 adults aged 50 to 80 years visiting a pharmacy during an influenza vaccination campaign and also due for CRCS. INTERVENTION On five dates, eligible patients were provided education and encouraged to obtain screening from their primary care clinician. On 17 dates, a home fecal immunochemical test (FIT) for CRCS was provided. A 16-item questionnaire was administered by phone 3 to 6 months after study enrollment. MAIN OUTCOME MEASURE Self-reported CRCS activity, comparing CRCS completion rates for participants provided with the FIT versus those provided with education and encouragement to obtain screening from patients' primary care clinician. RESULTS 86 participants in the FIT arm and 28 the CRCS education arm were interviewed. Interviews revealed that 19.8% of the FIT group and 50% of the CRCS education group discussed CRCS with their primary care clinician (P = 0.002). Of these participants, 59.3% in the FIT arm and 14.8% in the CRCS education arm reported completing screening (P < 0.001). Of participants in the FIT group, 52.2% completed FIT dispensed to them by the investigators. Most participants in both groups reported interest in receiving CRCS education and home CRCS tests from pharmacists in the future. CONCLUSION Pharmacy patients are receptive to CRCS interventions delivered in community pharmacies. Providing FIT to eligible patients during a pharmacy-based influenza vaccination campaign increases screening rates more than CRCS education alone.