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Put Prevention into Practice programs increased colorectal cancer screening adherence
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Enhanced office and patient management systems increased the number of patients who were likely to undergo recommended lower endoscopic screening for colorectal cancer compared with patients in non-enhanced systems.
The researchers identified 10 primary cancer physician group practices in the Physician Research in Office Network program for the study. They examined the effects of tailored vs. nontailored physician recommendation letters and enhanced vs. nonenhanced physician office and patient management interventions on 599 patients aged between 55 and 79 years who were eligible for screening. Patients completed a questionnaire between June 2002 and April 2004.
Nontailored letters did not include a personalized salutation or patient-specific content; tailored letters did. Letters recommending endoscopic colorectal cancer screening were sent to patients who were then asked to telephone for an appointment. The enhanced office and patient management systems tracked three-month patient acceptance of referral for screening, used a motivational interview method for counseling, and enhanced scheduling, transportation and insurance assistance.
During a period of one year, 48.2% of patients underwent endoscopy in the lower gastrointestinal tract. Among those who underwent screening, 53.3% received both the tailored letter and enhanced management, 54.2% received the nontailored letter and enhanced management, 43.6% received the tailored letter and nonehanced management and 37.9% received neither.
According to the researchers, enhanced office and patient management increased the odds of completing a colonoscopy or flexible sigmoidoscopy by 1.63-fold (95% CI, 1.11-2.41). The tailored letter was slightly less effective; it increased the odds of completion by 1.08-fold (95% CI, 0.72-1.62).
Arch Intern Med. 2009;169:47-55.