Improving uptake of colorectal cancer screening by complex patients at an academic primary care practice: a feasibility study.

Details

Serval ID
serval:BIB_831577921523
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Improving uptake of colorectal cancer screening by complex patients at an academic primary care practice: a feasibility study.
Journal
BMJ open quality
Author(s)
Desponds C., Ducros C., Rochat C., Galassini L., Bodenmann P., Grazioli V.S., Plys E., von Plessen C., Gouveia A., Selby K.
ISSN
2399-6641 (Electronic)
ISSN-L
2399-6641
Publication state
Published
Issued date
28/08/2024
Peer-reviewed
Oui
Volume
13
Number
3
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Regular screening reduces mortality from colorectal cancer (CRC). The Canton of Vaud, Switzerland, has a regional screening programme offering faecal immunochemical tests (FITs) or colonoscopy. Participation in the screening programme has been low, particularly among complex patients. Patient navigation has strong evidence for increasing the CRC screening rate.
This feasibility study tested patient navigation performed by medical assistants for complex patients at an academic primary care practice.
A review of 328 patients' medical charts revealed that 51% were up-to-date with screening (16% within the programme), 24% were ineligible, 5% had a documented refusal and 20% were not up-to-date, of whom 58 (18%) were complex patients. INTERVENTION FEBRUARY 2023 TO MAY 2023: We tried to help complex patients participate in the screening programme using either in-person or telephone patient navigation. Each intervention was piloted by a physician-researcher and then performed by a medical assistant. Based on the reach, effectiveness, adoption, implementation, maintenance framework, we collected: Intervention participation and refusal, screening acceptance and completion and both patients and medical assistant acceptability (ie, qualitative interviews).
Only 4/58 (7%) patients participated in the in-person patient navigation test phase due to scheduling problems. All four patients accepted a prescription and 2/4 (50%) completed their test. We piloted a telephone intervention to bypass scheduling issues but all patients refused a telephone discussion with the medical assistant. At two months after the last intervention, the proportion of patients up-to-date increased from 51% to 56%.
Our overall approach was resource-intensive and had little impact on the overall participation rate. It was likely not sustainable. New approaches and reimbursement for a specific patient navigator role are needed to increase CRC screening of complex patients.
Keywords
Humans, Colorectal Neoplasms/diagnosis, Feasibility Studies, Male, Primary Health Care/statistics & numerical data, Female, Early Detection of Cancer/methods, Early Detection of Cancer/statistics & numerical data, Middle Aged, Aged, Switzerland, Mass Screening/methods, Mass Screening/statistics & numerical data, Patient Navigation/statistics & numerical data, Patient Acceptance of Health Care/statistics & numerical data, Patient Acceptance of Health Care/psychology, CANCER, Complexity, Primary care
Pubmed
Web of science
Open Access
Yes
Create date
09/09/2024 9:28
Last modification date
27/09/2024 16:45
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