Point of care screening model outperforms conventional breast cancer screening methods

PHILADELPHIA — Health care providers who followed a point of care integrated breast cancer screening model referred more patients, and had more patients get mammograms, than those providers who referred only at preventive care visits, according to a presenter here at the annual meeting of the American Association of Nurse Practitioners.

“While mammograms reduce mortality through early detection, utilization is low, especially among uninsured and racial and ethnic minorities, often due to lack of provider referrals,” Jill Muhrer, APN, Cooper University Health Care, Camden, New Jersey, told Healio Family Medicine.

Jill Muhrer

To illustrate this point, she cited data from other sources indicating that in 2013, 65.9% of women aged 40 and older had completed mammograms, compared with 70% in 2003, and that the primary reason women cite for not receiving mammograms is lack of a medical provider making a recommendation.

For her study, Muhrer analyzed mammogram patterns among eight providers within a federally qualified health center. The point of care integrated screening model (n = 5,740) involved medical professionals who referred eligible patients at any and all appointments, regardless of the reason for the visit. The conventional screening group (n = 3,717) comprised medical professionals who referred only at preventive care visits.

Muhrer reported that she found a statistically significant differencebetween the two groups. Specifically, the point of care screening group had 43% of patients referred for mammograms, with 42% obtaining one, compared with the conventional group, where 37% of patients were referred and just 16% undergoing mammograms.

“The statistically significant findings of this small quality improvement project suggest that the use of [a point of care integrated screening model] can improve mammography referral and screening rates in [federal qualified health centers], and in doing so, can translate evidence-based recommendations into preventive clinical practices that can ultimately save lives through early detection and treatment,” Muhrer said.

“Integrating this approach through the patient-centered medical care model improves breast cancer screening referrals by reinforcing the patient-provider relationship through personalized care teams that stress mutual understanding of cultural definitions of breast cancer screening and that support shared decision-making.” – by Janel Miller

Reference:

Muhrer J. “Breast cancer referral and screening rates in a federally qualified health center: Implementing the point of care integrated breast cancer screening model.” Presented at: American Association of Nurse Practitioners National Conference; Jun. 20-25, 2017; Philadelphia.