The effect of patient and physician reminders on use of screening mammography in a health maintenance organization. Results of a randomized controlled trial.
Cancer
; 78(8): 1708-21, 1996 Oct 15.
Article
en En
| MEDLINE
| ID: mdl-8859184
ABSTRACT
BACKGROUND:
Despite its demonstrated efficacy in reducing breast carcinoma mortality, screening mammography remains underutilized and its promotion in the primary care setting provides an important opportunity for intervention.METHODS:
A randomized controlled trial was conducted in two sites of a health maintenance organization (HMO) serving an urban, minority population to evaluate the impact of patient and physician reminders on site visitation and mammography use. Eligible women (n = 2368) were randomly assigned to 1 of 4 intervention combinations (patient and physician reminders individually, together, or neither). The patient reminder letter invited mammography-due women to visit. The physician reminder was a notice placed in the medical record of mammography-due women. Logistic analysis and survival analysis were used to investigate the relationship of intervention status to visitation, time to a visit, and mammography use.RESULTS:
The patient reminder intervention had no effect upon rates of study year visitation or mammography at either site. However, among HMO Site 2 enrollees with entitlement insurance, the median time to the next visit was reduced from 12 to 9 weeks in association with assignment to patient reminder intervention. The physician reminder intervention was also effective in increasing the rate of completed mammography at Site 2 among all assignees (36% vs. 22% for those with vs. those without physician reminders) and among assignees who visited (59% vs. 43%).CONCLUSIONS:
Patient reminder letters had limited impact on visitation in this setting. Physician reminders are more effective but sites vary in their responsiveness. Further improvement in mammography utilization will require a better understanding of the determinants of patient and physician behavior.
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Colección:
01-internacional
Asunto principal:
Pautas de la Práctica en Medicina
/
Neoplasias de la Mama
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Mamografía
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Aceptación de la Atención de Salud
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Sistemas Prepagos de Salud
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Sistemas Recordatorios
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Promoción de la Salud
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Screening_studies
Límite:
Adult
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Aged
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Cancer
Año:
1996
Tipo del documento:
Article
País de afiliación:
Estados Unidos