Increasing referral rate for screening colonoscopy through patient education and activation at a primary care clinic in New York City

被引:12
作者
Sriphanlop, Pathu [1 ]
Hennelly, Marie Oliva [1 ]
Sperling, Dylan [1 ]
Villagra, Cristina [1 ]
Jandorf, Lina [1 ]
机构
[1] Icahn Sch Med Mt Sinai, Dept Oncol Sci, Div Canc Prevent & Control, New York, NY 10029 USA
关键词
Cancer; Cancer screening; Quality improvement; Colonoscopy; Colorectal cancer screening; Patient education; Patient activation; PHYSICIAN RECOMMENDATION; UNITED-STATES; CANCER; COMMUNICATION; FACILITATORS; BARRIERS; TRIAL;
D O I
10.1016/j.pec.2016.03.005
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective: Colorectal cancer could be prevented through regular screening. Individuals age 50 and older are recommended to get screened via colonoscopy. Because physician referral is a major predictor of colonoscopy completion, two low-cost, evidence-based interventions were tested to increase referrals by activating patients to self-advocate. Methods: This study compared the impact of a pre-visit educational handout that prompts patients to discuss colonoscopy with their physician with the handout plus brief counseling through exit interviews and chart reviews. The main outcome was physician referral. Results: Medical charts were reviewed for eligibility: 130 control patients (Arm 1), 45 patients who received the educational handout and health counseling (Arm 2), and 50 patients who received only the handout (Arm 3). Colonoscopy referral rates increased from 24.6% in Arm 1 to 44.4% and 52.0% in Arms 2 and 3, respectively (p = 0.001). The proportion of exit interview participants who discussed colonoscopy with their doctor increased from 68.8% in Arm 1 to 76.5% and 88.9% in Arms 2 and 3, respectively. Conclusions: Results indicate that both interventions are effective at increasing colonoscopy referrals. Practical implications: Results suggest that an educational handout alone is sufficient in prompting patient-initiated discussions about colonoscopy. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:1427 / 1431
页数:5
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