 |
|
Improving Colorectal Cancer Screening by Targeting Office Systems in Primary Care Practices
Disseminating Research Results Into Clinical Practice
Esther K. Wei, ScD;
Catherine T. Ryan, MPH;
Allen J. Dietrich, MD;
Graham A. Colditz, MD, DrPH
Arch Intern Med. 2005;165:661-666.
Background Randomized trials have shown the efficacy of an office systems approach in improving colorectal cancer (CRC) screening behaviors; its feasibility in real-world primary care practices has not been well studied.
Methods Between August 1, 2000, and December 1, 2001, we enrolled 185 primary care clinicians identified through purchased database lists. At the end of follow-up (December 31, 2002), 127 clinicians had completed preintervention and postintervention questionnaires. Trained staff from the American Cancer Society visited practices and identified areas for improvement in CRC screening. They provided clinicians with resources, tools, and support to facilitate positive change. We defined 5 clinician behavior areas related to successful CRC screening, including educating patients, identifying patients due for screening, enabling patient compliance, monitoring patient compliance, and notifying patients of their test results. We measured these areas before and after the intervention using questionnaires and data extracted from medical records.
Results We demonstrated improvements in the passive use of posters and brochures about CRC screening (baseline, 20.5% and follow-up, 69.3%; P<.001) and in the monitoring of fecal occult blood tests using manual tracking systems (baseline, 20.6% and follow-up, 37.3%; P<.05). Based on medical records data among 551 patients, we found a statistically significant increase in the number of patients who became up-to-date with CRC screening recommendations and tests (P< .001 for both).
Conclusion Methods shown to improve CRC screening processes in protocol-driven randomized trials may be effective in community practice, and wider dissemination of these strategies shows promise to increase CRC screening.
Author Affiliations: Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School (Drs Wei and Colditz and Ms Ryan), and Department of Epidemiology (Drs Wei and Colditz) and Harvard Center for Cancer Prevention (Ms Ryan and Dr Colditz), Harvard School of Public Health, Boston, Mass; and Department of Community and Family Medicine and Norris Cotton Cancer Center, Dartmouth Medical School, Hanover, NH (Dr Dietrich).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
How to Increase Colorectal Cancer Screening Rates in Practice
Sarfaty and Wender
CA Cancer J Clin 2007;57:354-366.
ABSTRACT
| FULL TEXT
Encouragement of Patient Self-management and Adherence through Use of a Computerized Tracking System for Cervical and Colon Cancer Screening
Bock and Kwan
J Am Board Fam Med 2007;20:316-319.
FULL TEXT
|
