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Evaluation of doctors' reminders in emergency departments to encourage cervical screening
1Needs Assessment & Health Outcomes Unit, Central Sydney Area Health Service, New South Wales. jward@nah.rpa.cs.nsw.gov.au
Objective:
To evaluate opportunistic reminders in emergency departments (EDs) about cervical smears.
Method:
Five EDs in Sydney in 1995-96 participated in a block-randomised control trial, whereby unscreened women at risk for cervical cancer who were seen as nonacute cases were allocated either to brief advice at the end of the ED consultation to return to their GP for a smear (intervention) or usual care (control). Blinded follow-up telephone interviews determined women's compliance four weeks later.
Results:
217 women at risk for cervical cancer presented, of whom 53 (23%) were overdue for a Pap smear (22 intervention group; 31 control group). At follow-up, no women in the intervention group had had a smear, although 3 (10%) in the control group had (p = 0.25).
Conclusions:
Opportunities in EDs in NSW for opportunistic reminders are infrequent and, even if taken, are unlikely to encourage screening over and above usual care.
Implications:
General practice remains a more effective location for opportunistic recruitment, although interventions with hospitalised in-patients also show greater promise than reminders in EDs.