Impact of a physician-oriented intervention on follow-up in colorectal cancer screening

Myers, Ronald E.; Turner, Barbara J.; Weinberg, David S.; Hyslop, Terry; Hauck, Walter W.; Brigham, Timothy P.; Rothermel, Todd; Grana, James; Schlackman, Neil

doi:10.1016/j.ypmed.2003.11.010

Cited by 83 publications

(84 citation statements)

References 28 publications

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“…These include telephone and mailed reminders and educational interventions to address fear of cancer diagnosis (19). Myers et al (20) showed that a physician-based intervention of reminderfeedback and educational outreach improved the evaluation of positive FOBT. It is difficult to extrapolate these data to the Veterans Affairs setting.…”

Section: Discussionmentioning

confidence: 99%

Barriers to Full Colon Evaluation for a Positive Fecal Occult Blood Test

Fisher¹,

Jeffreys²,

Coffman

et al. 2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Failure to appropriately evaluate a positive cancer screening test may negate the value of doing that test. The primary aim of this study was to explore the factors associated with undergoing a full colon evaluation for a positive fecal occult blood test (FOBT) in a single Veterans Affairs center. Methods: Medical records of consecutive patients ages z50 years, who had a positive screening FOBT from March 2000 to February 2001, were abstracted. Patient demographics, dates of ordering and doing follow-up test(s), and adherence with scheduled procedures were collected. The primary outcome, full colon evaluation, was defined as having a colonoscopy or double-contrast barium enema plus flexible sigmoidoscopy completed within 12 months. Results: The sample (N = 538) was 98% men (58% Caucasian, 29% African-American, and 13% unknown race). Approxi-

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Section: Discussionmentioning

confidence: 99%

Barriers to Full Colon Evaluation for a Positive Fecal Occult Blood Test

Fisher¹,

Jeffreys²,

Coffman

et al. 2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Given their relationship with patients and repeated contact with them, PCPs may be instrumental in ensuring that patients with positive FIT/FOBT tests complete follow-up colonoscopy. 14,15 Thus far, however, this relationship has not been explored.…”

Section: Introductionmentioning

confidence: 99%

Association Between Primary Care Visits and Colorectal Cancer Screening Outcomes in the Era of Population Health Outreach

et al. 2016

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BACKGROUND: Population outreach strategies are increasingly used to improve colorectal cancer (CRC) screening. The influence of primary care on cancer screening in this context is unknown. OBJECTIVE: To assess associations between primary care provider (PCP) visits and receipt of CRC screening and colonoscopy after a positive fecal immunochemical (FIT) or fecal occult blood test (FOBT). DESIGN: Population-based cohort study. PARTICIPANTS: A total of 968,072 patients ages 50-74 years who were not up to date with CRC screening in 2011 in four integrated healthcare systems (three with screening outreach programs using FIT kits) in the PopulationBased Research Optimizing Screening through Personalized Regimens (PROSPR) consortium. MEASURES: Demographic, clinical, PCP visit, and CRC screening data were obtained from electronic health records and administrative databases. We examined associations between PCP visits in 2011 and receipt of FIT/ FOBT, screening colonoscopy, or flexible sigmoidoscopy (CRC screening) in 2012 and follow-up colonoscopy within 3 months of a positive FIT/FOBT in 2012. We used multivariable logistic regression and propensity score models to adjust for confounding. RESULTS: Fifty-eight percent of eligible patients completed a CRC screening test in 2012, most by FIT. Those with a greater number of PCP visits had higher rates of CRC screening at all sites. Patients with ≥1 PCP visit had nearly twice the adjusted-odds of CRC screening (OR = 1.88, 95 % CI: 1.86-1.89). Overall, 79.6 % of patients with a positive FIT/FOBT completed colonoscopy within 3 months. Patients with ≥1 PCP visit had 30 % higher adjusted odds of completing colonoscopy after positive FIT/FOBT (OR = 1.30; 95 % CI: 1.22-1.40). CONCLUSIONS:Patients with a greater number of PCP visits had higher rates of both incident CRC screening and colonoscopy after positive FIT/FOBT, even in health systems with active population health outreach programs. In this era of virtual care and population outreach, primary care visits remain an important mechanism for engaging patients in cancer screening.KEY WORDS: primary care; colorectal cancer screening; population health outreach.

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“…Studies have repeatedly shown that interventions which target physician recommendation of colorectal and breast cancer screening are significantly more effective than those that only target the patient. [21][22][23][24] Accordingly, the primary objective of this study was to explore physicians' barriers of and facilitators to recommendation of CRCS. In contrast to previous studies of physician recommendation of screening, which have relied either on physician self-report which overestimates true rates, 25,26 or chart abstraction, which is limited by recording bias, 27 this study used a triangulation of qualitative methods that included in-depth interviews, chart-stimulated recall, and focus groups.…”

mentioning

confidence: 99%