Multilevel primary care intervention improves follow-up of overdue abnormal cancer screening tests
By Elana Gotkine HealthDay Reporter
FRIDAY, Oct. 13, 2023 (HealthDay News) — A multilevel primary care intervention including electronic health record (EHR) reminders and patient outreach improves timely follow-up of overdue cancer screening test results, according to a study published in the Oct. 10 issue of the Journal of the American Medical Association.
Steven J. Atlas, M.D., M.P.H., from Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues conducted a cluster randomized clinical trial at 44 primary care practices within three health networks enrolling patients with at least one abnormal cancer screening test result. Follow-up actions and times for abnormal screening results were recommended using automated algorithms developed using data from electronic health records. Primary care practices were randomly assigned to usual care; EHR reminders; EHR reminders and outreach; or EHR reminders, outreach, and navigation.
A total of 11,980 patients with an abnormal cancer screening test result for colorectal cancer, cervical cancer, breast cancer, or lung cancer (69, 22, 8, and 1 percent, respectively) and abnormal test results categorized as low, medium, or high risk (51, 31, and 18 percent, respectively) were included. The researchers found that 31.4, 31.0, 22.7, and 22.9 percent of patients in the EHR reminders, outreach, and navigation group; EHR reminders and outreach group; EHR reminders group; and usual care group completed recommended follow-up within 120 days, respectively. Similar results were seen for completion of recommended follow-up within 240 days and by subgroups for cancer type and level of risk for the abnormal screening result.
“Compared with patients treated at practices randomized to usual care or passive EHR reminders, completion of follow-up within 120 days of enrollment was higher among patients in practices randomized to EHR reminders and outreach (via letters and phone calls with or without patient navigation),” the authors write.
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