Medical Care Intervention Improved Follow-Up of Abnormal Cancer Screening Results

Oncology/Hematology
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Other Cancers

— Follow-up screening within 120 days was enhanced with EHR tips, client outreach, navigation

by Mike Bassett, Staff Writer, MedPage Today
October 10, 2023

A multilevel medical care intervention that consisted of automated electronic health record (EHR) pointers and client outreach/navigation enhanced prompt follow-up of past due unusual cancer evaluating test outcomes, a cluster randomized trial revealed.

Amongst almost 12,000 clients with an unusual screening test result for colorectal, cervical, breast, or lung cancer, conclusion of follow-up screening within 120 days of research study registration was considerably greater with EHR pointers, client outreach, and client navigation (31.4%) and EHR tips and client outreach (31.0%) compared to only EHR suggestions (22.7%), and normal care (22.9%), reported Steven J. Atlas, MD, MPH, of Massachusetts General Hospital in Boston, and associates.

The adjusted outright distinction for contrast of the EHR suggestions, outreach, and navigation group versus normal care was 8.5% (P< 0.001), they kept in mind in JAMA

Outcomes were comparable for conclusion of suggested follow-up at 240 days and throughout cancer types and levels of threat.

“Gaps in follow-up care requirement to be attended to if the complete advantages of preventive cancer screening are to be recognized,” Atlas and group composed, recommending that beyond the requirement for suggestions, informing clients about the significance of test outcomes, what follow-up treatments include, and evaluating client choices must likewise be attended to.

In subgroup analyses, clients with irregular cancer screening test results for cervical cancer who got EHR pointers, outreach, and navigation (OR 1.28, 95% CI 0.93-1.77) and those who got EHR tips and outreach (OR 1.51, 95% CI 1.09-2.09) had higher chances of finishing follow-up screening compared to clients who got normal care.

The very same held true for clients with irregular cancer screening test results for colorectal cancer in the EHR pointers, outreach, and navigation group (OR 1.68, 95% CI 1.32-2.16) and those in the EHR tips and outreach group (OR 1.71, 95% CI 1.33-2.19).

Compared to clients in the typical care group, clients with low- or medium-risk irregular cancer evaluating test outcomes had higher chances of finishing follow-up with EHR pointers, outreach, and navigation (OR for low threat: 1.66, 95% CI 1.36-2.02; OR for medium threat: 1.57, 95% CI 1.25-1.96) and with EHR tips and outreach (OR for low danger: 1.58, 95% CI 1.28-1.95; OR for medium threat: 1.55, 95% CI 1.23-1.96).

For this trial, 11,980 clients throughout 44 medical care practices within 3 health networks in the U.S. were consisted of. Mean age was 60 years, 64.8% were ladies, and 83.3% were white. All had at least one past due unusual cancer evaluating test outcome: 69% for colorectal cancer, 22% for cervical cancer, 8% for breast cancer, and 1% for lung cancer. Irregular test outcomes were classified as low danger (51%), medium danger (31%), or high danger (18%).

Individuals were randomized 1:1:1:1 to 4 groups: typical care (outreach and the capability to see test lead to an online client website); EHR pointers; EHR tips and outreach (clients got a letter and a telephone call); or EHR tips, outreach, and navigation (clients got a letter and a navigator outreach call). Clients were followed from August 2020 to December 2021.

The authors kept in mind that a person of the constraints of the research study was the truth that it was carried out throughout the COVID-19 pandemic, which likely added to more clients having past due irregular test outcomes, and not finishing follow-up screening.

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  Mike Bassett is a personnel author concentrating on oncology and hematology. He is based in Massachusetts.

Disclosures

The research study was moneyed by the National Cancer Institute and the American Cancer Society.

The research study authors reported no disclosures.

Main Source

JAMA

Source Reference: Atlas SJ, et al “A multilevel medical care intervention to enhance follow-up of past due irregular cancer evaluating test outcomes” JAMA 2023; DOI: 10.1001/ jama.2023.18755.

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