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dc.contributor.authorEmery, Jon D
dc.contributor.authorMurray, Sonya R
dc.contributor.authorWalter, Fiona
dc.contributor.authorMartin, Andrew
dc.contributor.authorGoodall, Stephen
dc.contributor.authorMazza, Danielle
dc.contributor.authorHabgood, Emily
dc.contributor.authorKutzer, Yvonne
dc.contributor.authorBarnes, David John
dc.contributor.authorMurchie, Peter
dc.date.accessioned2019-01-22T00:31:30Z
dc.date.available2019-01-22T00:31:30Z
dc.date.issued2019-04
dc.identifier.issn0040-6376
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/288323
dc.description.abstractBACKGROUND: 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. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trial Registry (1261300039 3752). This was registered pre-results.
dc.description.sponsorshipNational Health and Medical Research Council (NHMRC grant ID 1064121).
dc.format.mediumPrint-Electronic
dc.languageeng
dc.publisherBMJ
dc.rightsAttribution-NonCommercial 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.subjectHumans
dc.subjectLung Neoplasms
dc.subjectRespiration Disorders
dc.subjectSelf Care
dc.subjectSmoking
dc.subjectHealth Behavior
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectPrimary Health Care
dc.subjectPatient Acceptance of Health Care
dc.subjectAustralia
dc.subjectFemale
dc.subjectMale
dc.subjectEarly Detection of Cancer
dc.subjectDiagnostic Self Evaluation
dc.subjectSmokers
dc.titleThe Chest Australia Trial: a randomised controlled trial of an intervention to increase consultation rates in smokers at risk of lung cancer.
dc.typeArticle
prism.endingPage370
prism.issueIdentifier4
prism.publicationDate2019
prism.publicationNameThorax
prism.startingPage362
prism.volume74
dc.identifier.doi10.17863/CAM.35639
dcterms.dateAccepted2018-12-03
rioxxterms.versionofrecord10.1136/thoraxjnl-2018-212506
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2019-04
dc.contributor.orcidEmery, Jon D [0000-0002-5274-6336]
dc.contributor.orcidWalter, Fiona [0000-0002-7191-6476]
dc.identifier.eissn1468-3296
rioxxterms.typeJournal Article/Review
cam.issuedOnline2019-01-10


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Attribution-NonCommercial 4.0 International
Except where otherwise noted, this item's licence is described as Attribution-NonCommercial 4.0 International