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.