Improving Physician Compliance With Preventive Medicine Guidelines

Cohen, David I.; Littenberg, Benjamin; Wetzel, Cheryl; Neuhauser, Duncan

doi:10.1097/00005650-198210000-00006

Cited by 214 publications

(59 citation statements)

References 3 publications

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“…Because mammography is used so infrequently in the community at large, small increases in utilization have a greater likelihood of being statistically sig nificant without indicating a meaningful change. 43 Their intervention consisted of a checklist and radiology requests attached to the patient's chart by a trained assistant. Over a four-month period, house-officer compliance with mammography guidelines for women age 50 to 60 reached 32 percent in the intervention group.…”

Section: Increasing the Use Of Mammographymentioning

confidence: 99%

Using Mammography for Cancer Control: An Unrealized Potential

Howard

1987

CA: A Cancer Journal for Clinicians

134

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Section: Increasing the Use Of Mammographymentioning

confidence: 99%

Using Mammography for Cancer Control: An Unrealized Potential

Howard

1987

CA: A Cancer Journal for Clinicians

134

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“…After the exclusion guidelines were applied, 3,823 individuals were eligible for inclusion in the study. These included 819 adult males aged 17-44, 248 males aged 45-65, 878 females aged 17-44, and 331 females aged 45-65, 647 children aged 0-6, and 803 children aged [7][8][9][10][11][12][13][14][15][16]. We also included the 97 newborns who were both born into the study and remained in the study for at least 18 months.…”

Section: Introductionmentioning

confidence: 99%

Preventive care: do we practice what we preach?

Lurie¹,

Manning²,

Peterson³

et al. 1987

Am J Public Health

192

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“…Primary care physicians have been urged to "put prevention into practice" with each patient contact, 7 but few specialists are prepared to utilize each patient contact this way. Physicianoriented interventions such as education, 8 feedback of screening rates, 9 checklists, 10,11 nurse-generated reminders, 12 and computer-generated reminders 9,13 have been modestly successful in increasing cancer screening in primary care settings. Although these methods have not been tested outside the primary care setting, none of them seemed likely to overcome the fundamental barriers to screening by specialist physicians.…”

mentioning

confidence: 99%

Increasing breast and cervical cancer screening in low-income women

et al. 1998

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OBJECTIVE:To determine if women would have higher breast and cervical cancer screening rates if lay health advisers recommended screening and offered a convenient screening opportunity. DESIGN: Controlled trial. SETTING: Urban county teaching hospital.PARTICIPANTS: Women aged 40 years and over attending appointments in several non-primary-care outpatient clinics. INTERVENTIONS:Lay health advisers assessed the participants' breast and cervical cancer screening status and offered women in the intervention group who were due for screening an appointment with a female nurse practitioner. MEASUREMENTS AND MAIN RESULTS:Screening rates at baseline and at follow-up 1 year after the intervention were determined. At follow-up, the mammography rate was 69% in the intervention group versus 63% in the usual care group ( p ‫؍‬ .009), and the Pap smear rate was 70% in the intervention group versus 63% in the usual care group ( p ‫؍‬ .02). In women who were due for screening at baseline, the mammography rate was 60% in the intervention group versus 50% in the usual care group ( p ‫؍‬ .006), and the Pap smear rate was 63% in the intervention group versus 50% in the usual care group ( p ‫؍‬ .002). The intervention was effective across age and insurance payer strata, and was particularly effective in Native American women. CONCLUSIONS:Breast and cervical cancer screening rates were improved in women attending non-primary-care outpatient clinics by using lay health advisers and a nurse practitioner to perform screening. The effect was strongest in women in greatest need of screening.KEY WORDS: mass screening; vaginal smears; mammography; nurse practitioners; community health aides. J GEN INTERN MED 1998;13:515-521.S creening mammography and Pap smears have been shown convincingly to decrease breast and cervical cancer mortality. 1,2 Recent population-based surveys suggest progress toward the year 2000 goals in the general population for both breast and cervical cancer screening. 3,4 However, nonwhite women, older women, and those with lower incomes and less education generally have lower screening rates. [4][5][6] Strategies to improve screening rates in these groups are needed.Hennepin County Medical Center, the urban county teaching hospital in Minneapolis, serves many women from groups that are less likely to receive breast and cervical cancer screening. Preliminary reviews of the charts of women attending appointments in the general medicine clinic, medical subspecialty clinics, and surgical clinics, showed the lowest screening rates in women attending surgical clinics (K.L. Margolis, unpublished data). Primary care physicians have been urged to "put prevention into practice" with each patient contact, 7 but few specialists are prepared to utilize each patient contact this way. Physicianoriented interventions such as education, 8 feedback of screening rates, 9 checklists, 10,11 nurse-generated reminders, 12 and computer-generated reminders 9,13 have been modestly successful in increasing cancer screening in primary care setting...

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Improving Physician Compliance With Preventive Medicine Guidelines

Cited by 214 publications

References 3 publications

Using Mammography for Cancer Control: An Unrealized Potential

Using Mammography for Cancer Control: An Unrealized Potential

Preventive care: do we practice what we preach?

Increasing breast and cervical cancer screening in low-income women

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