Social determinants of health influencing the adherence to post-endoscopic mucosal resection surveillance.
Clin Res Hepatol Gastroenterol
; 48(4): 102301, 2024 Apr.
Article
in En
| MEDLINE
| ID: mdl-38355006
ABSTRACT
BACKGROUND AND AIMS:
Colorectal cancer (CRC) is a global health challenge, particularly in Alabama, where the incidence rates exceed national averages. This study investigated the factors influencing adherence to post-endoscopic mucosal resection (EMR) colonoscopies, focusing on travel distance and socioeconomic status. This study aimed to provide evidence-based insights to improve patient care in CRC management.METHODS:
This retrospective study in a tertiary care referral center analyzed 465 patients who underwent EMR. The data included demographics, clinical details, and travel-related variables. Descriptive statistics, logistic regression, and spatial analysis were used to assess the factors affecting adherence.RESULTS:
Of 465 patients, 36.6 % had adequate follow-up, 21.8 % had inadequate follow-up, and 41.6 % were lost to follow-up. Noteworthy demographic variations were observed, with median ages differing across adherence groups. Traveled distances showcased compelling insights, indicating a median distance of 22.2 miles for adequate follow-up, 15.7 miles for inadequate follow-up, and 31.6 miles for the lost-to-follow-up group (p<0.001). Longer travel distances were associated with better adherence. Longer travel distances from the hospital were associated with significantly lower odds of inadequate follow-up 10-25 miles OR0.29, 25-85 miles OR0.35, and >80 miles OR0.24 compared to the first quartile (<10 miles). Socioeconomic factors, particularly educational attainment, significantly influenced the follow-up rates.CONCLUSIONS:
This study revealed suboptimal post-EMR follow-up rates and underscored the impact of travel distance and socioeconomic factors. Targeted interventions addressing distance-related barriers can enhance treatment adherence and ensure timely CRC surveillance after EMR. Further research is needed in diverse healthcare settings.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Travel
/
Endoscopic Mucosal Resection
Type of study:
Observational_studies
/
Risk_factors_studies
/
Screening_studies
Aspects:
Determinantes_sociais_saude
Limits:
Humans
Language:
En
Journal:
Clin Res Hepatol Gastroenterol
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: