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Patient and Physician Reminders to Promote Colorectal Cancer Screening

An Evidence-Based Practice

Description

This program used mailed materials for patients and electronic reminders for physicians to promote colorectal cancer screening. The program targeted patients aged 50 to 80 years who were overdue for colorectal cancer screening. Patient mailings included an educational pamphlet, fecal occult blood test home screening kit and return envelope, and instructions for directly scheduling a flexible sigmoidoscopy or colonoscopy. The mailing included a letter from their health care provider indicating that they were overdue for screening. Electronic reminders were sent to health care providers during office visits with patients who were overdue for screening. The reminders appeared on the electronic visit summary screen, and included simplified electronic ordering of screening examinations.

Goal / Mission

The goal of this program is to increase colorectal cancer screening rates among older primary care patients.

Results / Accomplishments

In a randomized controlled trial patients and physicians receiving reminders were compared to a control group receiving usual care. In the 15 months following the intervention, screening rates were signiifcantly higher for patients who received mailings compared with those who did not (44.0% vs. 38.1%; p < 0.001). This effect increased with age, with a 3.7% increase for ages 50 to 59 years, 7.3% for ages 60 to 69, and 10.1% for ages 70 to 80 (p = 0.01 for trend). Screening rates were similar for patients of physicians receiving electronic reminders and the control group, however electronic reminders tended to increase screening rates among patients with 3 or more primary care visits (59.5% vs. 52.7%; p = 0.07). Detection of adenomas tended to increase with patient mailings (5.7% vs. 5.2%; p = 0.10) and physician reminders (6.0% vs. 4.9%; p = 0.09).

About this Promising Practice

Organization(s)
Harvard Medical School, Harvard Vanguard Medical Association
Primary Contact
Thomas Sequist
Department of Health Care Policy
Harvard Medical School
180 Longwood Ave.
Boston, MA 02115
(617) 432-3447
sequist@hcp.med.harvard.edu
http://www.hcp.med.harvard.edu/
Topics
Health / Cancer
Health / Prevention & Safety
Health / Health Care Access & Quality
Organization(s)
Harvard Medical School, Harvard Vanguard Medical Association
Source
Archives of Internal Medicine
Date of publication
Feb 2009
Date of implementation
Apr 2006
Location
Massachusetts
For more details
Target Audience
Adults, Older Adults