Christopher P Morley1, Laura A Schad1, Laurene M Tumiel-Berhalter2,3, Laura A Brady2, Alexandrea Bentham2, Karen Vitale4, Amanda Norton5, Gary Noronha6, Carlos Swanger6,7. 1. Department of Public Health and Preventive Medicine, State University of New York (SUNY) Upstate Medical University, Syracuse, NY. 2. Department of Family Medicine, SUNY University at Buffalo, Buffalo, NY. 3. University at Buffalo Clinical and Translational Science Institute, Buffalo, NY. 4. University of Rochester Clinical and Translational Science Institute, Rochester, NY. 5. A. Mandatory, Inc. (consulting for SUNY Upstate Medical University), Groton, NY. 6. Center for Primary Care, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY. 7. Health Reach for the Homeless, Rochester Regional Health, Rochester, NY.
Abstract
PURPOSE: In the United States, cancer screening rates are often below national targets. This project implemented practice facilitation and academic detailing aimed at increasing breast, cervical, and colorectal cancer screening rates in safety-net primary care practices. METHODS: Three practice-based research networks across western and central New York State partnered to provide quality improvement strategies on breast, cervical, and colorectal cancer screening. Pre/postintervention screening rates for all participating practices were collected annually, as were means across all practices over 7 years. Simple ordinary least squares linear regression was used to calculate the trend for each cancer type and test for statistical significance (ie, P≤0.05), using the ordinal time point as a fixed effect. RESULTS: An overall increase in mean screening rates was seen over the duration of this project for colorectal (24.6% preintervention to 48.0% in year 7 of intervention; P<0.001) and breast cancer (37.0% preintervention to 48.6% in year 7; P=0.460). Mean cervical cancer screening rates decreased (35.5% preintervention to 31.4% in year 7; P=0.209). Success in increasing screening rates varied across regions of New York State. CONCLUSIONS: Practice facilitation and academic detailing were successful in significantly increasing, on average, colorectal cancer screening rate. Cervical cancer screening showed an overall decrease, likely due to difficulties for primary care practices in tracking and implementation, as many patients seek this service at outside gynecology facilities. Regional differences, guideline changes, and practice reorganization each may have played a part in observed trends. A standardization of queries being used to pull screening rates is an important step in increasing the reliability of these data.
PURPOSE: In the United States, cancer screening rates are often below national targets. This project implemented practice facilitation and academic detailing aimed at increasing breast, cervical, and colorectal cancer screening rates in safety-net primary care practices. METHODS: Three practice-based research networks across western and central New York State partnered to provide quality improvement strategies on breast, cervical, and colorectal cancer screening. Pre/postintervention screening rates for all participating practices were collected annually, as were means across all practices over 7 years. Simple ordinary least squares linear regression was used to calculate the trend for each cancer type and test for statistical significance (ie, P≤0.05), using the ordinal time point as a fixed effect. RESULTS: An overall increase in mean screening rates was seen over the duration of this project for colorectal (24.6% preintervention to 48.0% in year 7 of intervention; P<0.001) and breast cancer (37.0% preintervention to 48.6% in year 7; P=0.460). Mean cervical cancer screening rates decreased (35.5% preintervention to 31.4% in year 7; P=0.209). Success in increasing screening rates varied across regions of New York State. CONCLUSIONS: Practice facilitation and academic detailing were successful in significantly increasing, on average, colorectal cancer screening rate. Cervical cancer screening showed an overall decrease, likely due to difficulties for primary care practices in tracking and implementation, as many patients seek this service at outside gynecology facilities. Regional differences, guideline changes, and practice reorganization each may have played a part in observed trends. A standardization of queries being used to pull screening rates is an important step in increasing the reliability of these data.
Authors: William J Curry; Eugene J Lengerich; Brenda C Kluhsman; Marie A Graybill; Jason Z Liao; Eric W Schaefer; Angela M Spleen; Mark B Dignan Journal: BMC Health Serv Res Date: 2011-05-23 Impact factor: 2.655
Authors: Roberto Cardarelli; Sarah Weatherford; Jennifer Schilling; Dana King; Sue Workman; Wade Rankin; Juanita Hughes; Jonathan Piercy; Amy Conley-Sallaz; Melissa Zook; Kendra Unger; Emma White; Barbara Astuto; Bobbi Stover Journal: J Patient Cent Res Rev Date: 2017-11-06