• Shakira R Onwuka, Jennifer McIntosh, Finlay Macrae, Patty Chondros, Lucy Boyd, Rushani Wijesuriya, Sibel Saya, Napin Karnchanachari, Kitty Novy, Mark A Jenkins, Fiona M Walter, Lyndal Trevena, GutierrezJaviera MartinezJM0000-0002-2493-9974Centre for Cancer Research, University of Melbourne; Department of General Practice and Primary Care, University of Melbourne, Melbourne, Australia; School of Medicine, Family Medicine Department, Pontificia U, Kate Broun, George Fishman, Julie Marker, and Jon Emery.
• Centre for Cancer Research, University of Melbourne; Department of General Practice and Primary Care, University of Melbourne; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
• Br J Gen Pract. 2024 Aug 1; 74 (745): e498e507e498-e507.

BackgroundAustralian guidelines recommend that people aged 50-70 years consider taking low-dose aspirin to reduce their risk of colorectal cancer (CRC).AimTo 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 SettingIndividually randomised controlled trial in six general practices in Victoria, Australia, from October 2020 to March 2021.MethodParticipants 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.ResultsA total of 261 participants (86% of eligible patients) were randomised into trial arms (n = 129 intervention; n = 132 control). Of these participants, 17.7% (n = 20/113) in the intervention group and 7.6% (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 = 12/118) of the intervention group versus 13.8% (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]).ConclusionThe 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.© The Authors.

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