Browsing by Author "Trevena, Lyndal"

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    An RCT of a decision aid to support informed choices about taking aspirin to prevent colorectal cancer and other chronic diseases: a study protocol for the SITA (Should I Take Aspirin?) trial
    (2021) Milton, Shakira; McIntosh, Jennifer; Macrae, Finlay; Chondros, Patty; Trevena, Lyndal; Jenkins, Mark; Walter, Fiona M.; Taylor, Natalie; Boyd, Lucy; Martínez Gutiérrez, Javiera
    Abstract Background Australian guidelines recommend that all people aged 50–70 years old actively consider taking daily low-dose aspirin (100–300 mg per day) for 2.5 to 5 years to reduce their risk of colorectal cancer (CRC). Despite the change of national CRC prevention guidelines, there has been no active implementation of the guidelines into clinical practice. We aim to test the efficacy of a health consultation and decision aid, using a novel expected frequency tree (EFT) to present the benefits and harms of low dose aspirin prior to a general practice consultation with patients aged 50–70 years, on informed decision-making and uptake of aspirin. Methods Approximately five to seven general practices in Victoria, Australia, will be recruited to participate. Patients 50–70 years old, attending an appointment with their general practitioner (GP) for any reason, will be invited to participate in the trial. Two hundred fifty-eight eligible participants will be randomly allocated 1:1 to intervention or active control arms using a computer-generated allocation sequence stratified by general practice, sex, and mode of trial delivery (face-to-face or teletrial). There are two co-primary outcomes: informed decision-making at 1-month post randomisation, measured by the Multi-dimensional Measure of Informed Choice (MMIC), and self-reported daily use of aspirin at 6 months. Secondary outcomes include decisional conflict at 1-month and other behavioural changes to reduce CRC risk at both time points. Discussion This trial will test the efficacy of novel methods for implementing national guidelines to support informed decision-making about taking aspirin in 50–70-year-olds to reduce the risk of CRC and other chronic diseases. Trial registration The Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620001003965 . Registered on 10 October 2020.
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    Should I Take Aspirin? (SITA): randomised controlled trial of a decision aid for cancer chemoprevention
    (2024) Onwuka, Shakira R.; McIntosh, Jennifer; Macrae, Finlay; Chondros, Patty; Boyd, Lucy; Wijesuriya, Rushani; Saya, Sibel; Karnchanachari, Napin; Novy, Kitty; Jenkins, Mark A.; Walter, Fiona M.; Trevena, Lyndal; Gutierrez, Javiera Martinez; Broun, Kate; Fishman, George; Marker, Julie; Emery, Jon
    Background Australian guidelines recommend that people aged 50-70 years consider taking low-dose aspirin to reduce their risk of colorectal cancer (CRC). Aim To determine the effect of a consultation with a researcher before an appointment in general practice using a decision aid presenting the benefits and harms of taking low- dose aspirin compared with a general CRC prevention brochure on patients' informed decision making and low- dose aspirin use. Design and setting Individually randomised controlled trial in six general practices in Victoria, Australia, from October 2020 to March 2021. Method Participants were recruited from a consecutive sample of patients aged 50-70 years attending a GP. The intervention was a consultation using a decision aid to discuss taking aspirin to reduce CRC risk while control consultations discussed reducing CRC risk generally. Self-reported co-primary outcomes were the proportion of individuals making informed choices about taking aspirin at 1 month and on low-dose aspirin uptake at 6 months, respectively. The intervention effect was estimated using a generalised linear model and reported with Bonferroni-adjusted 95% confidence intervals (CIs) and P-values. Results A total of 261 participants (86% of eligible patients) were randomised into trial arms (n n = 129 intervention; n = 132 control). Of these participants, 17.7% (n n = 20/113) in the intervention group and 7.6% (n n = 9/118) in the control group reported making an informed choice about taking aspirin at 1 month, an estimated 9.1% (95% CI = 0.29 to 18.5) between- arm difference in proportions (odds ratio [OR] 2.47, 97.5% CI = 0.94 to 6.52, P = 0.074). The proportions of individuals who reported taking aspirin at 6 months were 10.2% (n n = 12/118) of the intervention group versus 13.8% (n n = 16/116) of the control group, an estimated between-arm difference of -4.0% (95% CI = -13.5 to 5.5; OR 0.68 [97.5% CI = 0.27 to 1.70, P = 0.692]). Conclusion The decision aid improved informed decision making but this did not translate into long-term regular use of aspirin to reduce CRC risk. In future research, decision aids should be delivered alongside various implementation strategies.