Influence of provider discussion and specific recommendation on colorectal cancer screening uptake among U.S. adults

Laiyemo, Adeyinka O.; Adebogun, Akeem; Doubeni, Chyke A.; Ricks-Santi, Luisel; McDonald-Pinkett, Shelly; Young, Patrick E.; Cash, Brooks D.; Klabunde, Carrie N.

doi:10.1016/j.ypmed.2014.06.022

Cited by 50 publications

(34 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Incorporating colonoscopy into primary care practices may have the added benefit of ensuring continuity of care, decreasing costs to patients, and decreasing transportation barriers (including travel time). 40 Because a personal physician's recommendation is a strong predictor of CRC screening, [41][42][43][44] and trust in a primary care physician is also associated with CRC screening compliance, 13 primary care colonoscopy has great potential for decreasing CRC incidence and mortality. However, relatively few primary care physicians perform colonoscopies, 23 and only a fraction of family medicine residencies train residents to conduct colonoscopies.…”

Section: Discussionmentioning

confidence: 99%

Expanding Access to Colorectal Cancer Screening: Benchmarking Quality Indicators in a Primary Care Colonoscopy Program

McClellan

Ojinnaka

Pope

et al. 2015

The Journal of the American Board of Family Medicine

View full text Add to dashboard Cite

Background: An inadequate supply of physicians who perform colonoscopies contributes to suboptimal screening rates, especially among the underserved. This shortage could be reduced if primary care physicians perform colonoscopies. This purpose of this article is to report quality indicators from colonoscopy procedures performed by family medicine physicians as part of a colorectal cancer prevention program targeting uninsured, low-income individuals.Methods: A grant-funded colorectal cancer screening program was implemented to increase access to affordable colonoscopies for underinsured or uninsured residents of target counties while providing colonoscopy training to family medicine resident physicians. Colonoscopies were performed or supervised by 4 board-certified family physicians. Data were collected between 2011 and 2014.Results: A total of 1155 colonoscopies were performed on 1101 individuals over a 3-year period. Cecal intubation rate was 96.25%. Adenoma detection rates among men and women >50 years old were 38.15% and 25.96%, respectively. There was 1 perforation, which was referred to a hospital, and 1 instance of postprocedural bleeding, which spontaneously resolved.

show abstract

Section: Discussionmentioning

confidence: 99%

Expanding Access to Colorectal Cancer Screening: Benchmarking Quality Indicators in a Primary Care Colonoscopy Program

McClellan

Ojinnaka

Pope

et al. 2015

The Journal of the American Board of Family Medicine

View full text Add to dashboard Cite

show abstract

“…This was disappointing, since it is known healthcare providers recommendation of CRC screening enhances compliance with screening. [23,24] 4 In previous research, we found that screening rates using FIT were about 48% with a mailed FIT to patients due for screening and a 79% return when handed out to persons in a low-income population. [10,14] Our results are similar to other studies which found about half of the patients return a one-day FIT.…”

Section: Discussionmentioning

confidence: 99%

Free Fecal Immunochemical Test Disbursement in Eight Family Physician Offices

Daly

Levy

2015

J Community Health

View full text Add to dashboard Cite

Colorectal cancer (CRC) is the second leading cause of cancer death. CRC screening with a fecal immunochemical test (FIT) is important as occult blood may be detected. To offer Iowa Research Network members in family physician offices the opportunity to provide FITs at no charge to patients in need and determine how many of the tests would be handed out to patients and how many would be returned to the office. Eight family physician offices agreed to participate and 50 two-day FITs were provided, potentially providing 400 patients a CRC screening test. One hundred and eighty (45 %) of the 400 FITs were handed out to patients. Of the 92 (51 %) patients who returned at least one card, 77 (84 %) had negative results, 13 (14 %) were positive, and 2 (2 %) were indeterminate. Of 13 patients with a positive result, 11 (85 %) had a follow-up colonoscopy. Providing 400 FITs at no charge to the offices was an expensive endeavor. Implementing this forced a change in office routine and the type of fecal occult blood test used. Less than half of the FITs were given out to patients and of those given out, about half of the patients returned a FIT. For those who returned FITs and had positive findings, 85 % followed-up with a colonoscopy. Office nurses implementing the CRC screening need to be included in the planning of the type of fecal occult blood test used and receptive to the project

show abstract

“…[1][2][3] Traditionally, cancer screening is a core component of primary care, and adherence to screening recommendations is a key quality indicator for primary care physicians and practices. Colorectal cancer screening is particularly effective, and expanded screening is credited as contributing to at least some of the declining incidence and mortality from this condition.…”

Section: Introductionmentioning

confidence: 99%

Assessing the impact of colonoscopy complications on use of colonoscopy among primary care physicians and other connected physicians: an observational study of older Americans

et al. 2017

View full text Add to dashboard Cite

ObjectivesPsychological biases can distort treatment decision-making. The availability heuristic is one such bias, wherein events that are recent, vivid or easily imagined are readily ‘available’ to memory and are therefore judged more likely to occur than expected based on epidemiological data. We assessed if the occurrence of a serious colonoscopy complication for a primary care physician’s patient influenced colonoscopy rates for the physician’s other patients.DesignLongitudinal study with time-varying exposure variables.Setting/participantsIndividuals living in 51 hospital referral regions across the USA identified based on enrolment in fee-for-service Medicare during 2005–2010. We assigned patients to a primary care physician based on office visits during the prior 2 years.ExposuresFor each physician in each month, we calculated the proportion of patients assigned to them who had a colonoscopy. We identified two serious complications of which the primary care provider would very likely be aware: gastrointestinal bleed or perforation leading to hospitalisation or death within 14 days of colonoscopy.Main outcome measuresWe employed Poisson regression models including physician fixed effects to assess the change in number of colonoscopies in the four quarters following an adverse colonoscopy event.ResultsWe identified 5 360 191 patients assigned to 30 704 physicians. 4864 physicians (16%) had at least one patient with an adverse event. The estimated change in the quarterly number of colonoscopies among physicians’ patients was significantly lower in quarter 2 following an adverse colonoscopy event (change=−2.1% (95% CI −3.4 to −0.8%)), before returning to the rate expected in the absence of an adverse event.ConclusionsHaving a patient experience a serious adverse colonoscopy event was associated with a small and temporary decline in colonoscopy rates among a physician’s other patients. This finding provides empirical evidence for the influence of notable adverse events on care, possibly due to the availability heuristic.

show abstract

Influence of provider discussion and specific recommendation on colorectal cancer screening uptake among U.S. adults

Cited by 50 publications

References 16 publications

Expanding Access to Colorectal Cancer Screening: Benchmarking Quality Indicators in a Primary Care Colonoscopy Program

Expanding Access to Colorectal Cancer Screening: Benchmarking Quality Indicators in a Primary Care Colonoscopy Program

Free Fecal Immunochemical Test Disbursement in Eight Family Physician Offices

Assessing the impact of colonoscopy complications on use of colonoscopy among primary care physicians and other connected physicians: an observational study of older Americans

Contact Info

Product

Resources

About