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Showing content from https://pubmed.ncbi.nlm.nih.gov/30657396/ below:

Linking Reminders and Physician Breast Cancer Screening Recommendations: Results From a National Survey

doi: 10.1200/CCI.17.00090. Linking Reminders and Physician Breast Cancer Screening Recommendations: Results From a National Survey

Affiliations

Affiliation

¹ Elizabeth J. Siembida, National Cancer Institute, Rockville; Craig Evan Pollack, Johns Hopkins University, Baltimore, MD; Archana Radhakrishnan, University of Michigan, Ann Arbor, MI; Sarah A. Nowak, RAND Corporation, Santa Monica, CA; and Andrew M. Parker, RAND Corporation, Pittsburgh, PA.

PMID: 30657396
PMCID: PMC6873794
DOI: 10.1200/CCI.17.00090

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Linking Reminders and Physician Breast Cancer Screening Recommendations: Results From a National Survey

Elizabeth J Siembida et al. JCO Clin Cancer Inform. 2017 Nov.

doi: 10.1200/CCI.17.00090. Affiliation

¹ Elizabeth J. Siembida, National Cancer Institute, Rockville; Craig Evan Pollack, Johns Hopkins University, Baltimore, MD; Archana Radhakrishnan, University of Michigan, Ann Arbor, MI; Sarah A. Nowak, RAND Corporation, Santa Monica, CA; and Andrew M. Parker, RAND Corporation, Pittsburgh, PA.

PMID: 30657396
PMCID: PMC6873794
DOI: 10.1200/CCI.17.00090

Item in Clipboard

Abstract

Purpose: Physician reminders have successfully increased rates of mammography. However, considering recent changes to breast cancer screening guidelines that disagree on the optimal age to start and stop mammography screening, we sought to examine the extent to which reminders have been deployed for breast cancer screening targeting younger and older patients.

Methods: A mailed survey was sent to a national sample of 2,000 primary care physicians between May and September 2016. Physicians were asked whether they received reminders to screen women in various age groups (40 to 44, 45 to 49, and ≥ 75 years), the organizational screening guidelines they trusted most, and whether they recommended routine breast cancer screening to average-risk women in the different age groups. Using regression models, we assessed the association between reminders and physician screening recommendations, controlling for physician and practice characteristics, and evaluated whether the association varied by the guidelines they trusted.

Results: A total of 871 physicians responded (adjusted response rate, 52.3%). Overall, 28.9% of physicians reported receiving reminders for patient ages 40 to 44 years, 32.5% for patient ages 45 to 49 years, and 16.5% for patient ages ≥ 75 years. Receiving reminders significantly increased the likelihood of physicians recommending mammography screening. In adjusted analyses, 84% (95% CI, 77% to 90%) of physicians who received reminders recommended screening for women ages ≥ 75 versus 65% (95% CI, 62% to 69%) of those who did not receive reminders. The associations between reminders and screening recommendations remained consistent regardless of which guidelines physicians reported trusting.

Conclusion: Reminders were significantly associated with increases in physician screening recommendations for mammography, underscoring the need for careful implementation in scenarios where guidelines are discordant.

PubMed Disclaimer

Conflict of interest statement Elizabeth J. Siembida

No relationship to disclose

Archana Radhakrishnan

No relationship to disclose

Sarah A. Nowak

No relationship to disclose

Andrew M. Parker

No relationship to disclose

Craig Evan Pollack

Stock and Other Ownership Interests: Amgen, Danaher, Dow Chemical, Ecolab, Gilead Sciences, GE Healthcare, Qiagen, Cerner, Illumina, Sanofi, Stericycle, Thermo Fisher Scientific, The Advisory Board Company, Novo Nordisk, Celgene, 3M

Figures
Fig 1.

Predicted probabilities and 95% CIs…

Fig 1.

Predicted probabilities and 95% CIs of screening recommendations as a function of receipt…

Fig 1.

Predicted probabilities and 95% CIs of screening recommendations as a function of receipt of reminders. Predicted probabilities are adjusted for being sued for failing to diagnose cancer, physician’s race/ethnicity, time since residency graduation, physician’s sex, full-time status in outpatient clinic, trusted guidelines, practice size, employer type, presence of an electronic medical record, physician’s specialty, percentage of patients uninsured/self-pay, and receipt of quality compensation.