The Utility of an Evidence-Based Lecture and Clinical Prompt as Methods to Improve Quality of Care in Colorectal Cancer Screening

Seres, Kenneth A.; Kirkpatrick, Angelia; Tierney, William M.

doi:10.1038/ajg.2009.73

Cited by 9 publications

(6 citation statements)

References 22 publications

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“…14 In another cohort trial, clinical prompts on the patient medical record significantly improved the probability that a screening test would be ordered. 15 Even when patients have had a prior colonoscopy, a physician reminder increases the use of surveillance colonoscopy. 16 Knowing that the recommendation of CRC screening is one of the strongest predictors of screening, it is important to discern the differences between those persons who receive a recommendation for CRC colonoscopy screening and then do obtain a colonoscopy compared with those who do not get screened after the recommendation.…”

Section: Introductionmentioning

confidence: 99%

Patients Whose Physicians Recommend Colonoscopy and Those Who Follow Through

Daly

Levy

2012

J Prim Care Community Health

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Section: Introductionmentioning

confidence: 99%

Patients Whose Physicians Recommend Colonoscopy and Those Who Follow Through

Daly

Levy

2012

J Prim Care Community Health

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“…Education alone does not seem to be an adequate method to improve screening rates. Seres et al [23] evaluated two comparison initiatives at the provider level to improve the quality of care in CRC screening: an evidence-based lecture regarding screening guidelines, compared to the lecture in addition to a written prompt on the patient chart for all applicable patients. The study found that clinical prompts significantly improved completion of CRC screenings among physician providers when compared to administering evidence-based lectures alone.…”

Section: Discussionmentioning

confidence: 99%

Resident Knowledge of Colorectal Cancer Screening Assessed by Web-Based Survey

et al. 2014

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BackgroundTo evaluate resident knowledge of colorectal cancer (CRC) screening guidelines and to define areas requiring attention.MethodsA survey was created using three published guidelines for CRC screening. Program directors for internal medicine residency programs were contacted within the metro New York City area to have their residents participate.ResultsFive programs participated, and 115 responses were recorded. For the appropriate testing and interval to screen for CRC, 61/115 residents identified flexible sigmoidoscopy every 5 years, 108/115 identified colonoscopy every 10 years, 16/115 identified double contrast barium enema (DCBE) every 5 years and only 12/115 thought CT-colography every 5 years was appropriate. Only 40/115 respondents appropriately identified fecal occult blood testing (FOBT) administered in the patient’s home annually, while fecal immunohistochemical testing (FIT) annually at home was identified by 8/115 residents.ConclusionWhile most residents seem knowledgeable regarding CRC screening with colonoscopy, many deficiencies remain. FOBT for screening purposes remains undervalued, and confusion about administering the test persists. The distinction between screening and prevention needs further reinforcement.

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“…Such practice-related barriers to providing CRC screening may present greater hurdles for FPs than internists, particularly in rural and underserved areas. Tailored practice-based interventions [25] including reminder systems [26], clinical outreach, programs to monitor disparate care in practices, and the use of preventive medicine specialists, supported by information technology solutions and incentive programs, may increase screening within primary care offices. Mitigating such hurdles has the potential to increase recommendations of CRC screening in primary care practices.…”

Section: Discussionmentioning

confidence: 99%

Self-reported colorectal cancer screening of Medicare beneficiaries in family medicine vs. internal medicine practices in the United States: a cross-sectional study

et al. 2012

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BackgroundThe benefit of screening for decreasing the risk of death from colorectal cancer (CRC) has been shown, yet many patients in primary care are still not undergoing screening according to guidelines. There are known variations in delivery of preventive health care services among primary care physicians. This study compared self-reported CRC screening rates and patient awareness of the need for CRC screening of patients receiving care from family medicine (FPs) vs. internal medicine (internists) physicians.MethodsNationally representative sample of non-institutionalized beneficiaries who received medical care from FPs or internists in 2006 (using Medicare Current Beneficiary Survey). The main outcome was the percentage of patients screened in 2007. We also examined the percentage of patients offered screening.ResultsPatients of FPs, compared to those of internists, were less likely to have received an FOBT kit or undergone home FOBT, even after accounting for patients' characteristics. Compared to internists, FPs' patients were more likely to have heard of colonoscopy, but were less likely to receive a screening colonoscopy recommendation (18% vs. 27%), or undergo a colonoscopy (43% vs. 46%, adjusted odds ratios [AOR], 95% confidence interval [CI]-- 0.65, 0.51-0.81) or any CRC screening (52% vs. 60%, AOR, CI--0.80, 0.68-0.94). Among subgroups examined, higher income beneficiaries receiving care from internists had the highest screening rate (68%), while disabled beneficiaries receiving care from FPs had the lowest screening rate (34%).ConclusionPatients cared for by FPs had a lower rate of screening compared to those cared for by internists, despite equal or higher levels of awareness; a difference that remained statistically significant after accounting for socioeconomic status and access to healthcare. Both groups of patients remained below the national goal of 70 percent.

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The Utility of an Evidence-Based Lecture and Clinical Prompt as Methods to Improve Quality of Care in Colorectal Cancer Screening

Abstract: Clinical prompts are superior to evidence-based lectures for improving physician colorectal cancer screening practices. These prompts are simple low-cost measures that can improve quality of care.

Cited by 9 publications

References 22 publications

Patients Whose Physicians Recommend Colonoscopy and Those Who Follow Through

Patients Whose Physicians Recommend Colonoscopy and Those Who Follow Through

Resident Knowledge of Colorectal Cancer Screening Assessed by Web-Based Survey

Self-reported colorectal cancer screening of Medicare beneficiaries in family medicine vs. internal medicine practices in the United States: a cross-sectional study

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