Multilevel Follow-up of Cancer Screening (mFOCUS): Protocol for a multilevel intervention to improve the follow-up of abnormal cancer screening test results.

Autor: Haas JS; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: Jennifer.Haas@mgh.harvard.edu., Atlas SJ; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Wright A; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA., Orav EJ; Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA., Aman DG; Information, Technology and Consulting (ITC), Dartmouth College, Lebanon, NH., Breslau ES; Division of Cancer Prevention and Control, National Cancer Institute, Rockville, MD, USA., Burdick TE; Department of Community and Family Medicine, Dartmouth-Hitchcock Health, Lebanon, NH; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Hanover, NH, USA., Carpenter E; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Chang F; Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA., Dang T; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Diamond CJ; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Feldman S; Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA., Harris KA; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Hort SJ; Department of Medicine, Dartmouth-Hitchcock Health, Lebanon, NH, USA., Housman ML; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Hanover, NH, USA., Mecker A; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Lehman CD; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Percac-Lima S; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Smith R; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Hanover, NH, USA., Wint AJ; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Yang J; Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA., Zhou L; Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA., Tosteson ANA; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Hanover, NH, USA; Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
Jazyk: angličtina
Zdroj: Contemporary clinical trials [Contemp Clin Trials] 2021 Oct; Vol. 109, pp. 106533. Date of Electronic Publication: 2021 Aug 08.
DOI: 10.1016/j.cct.2021.106533
Abstrakt: Introduction: While substantial attention is focused on the delivery of routine preventive cancer screening, less attention has been paid to systematically ensuring that there is timely follow-up of abnormal screening test results. Barriers to completion of timely follow-up occur at the patient, provider, care team and system levels.
Methods: In this pragmatic cluster randomized controlled trial, primary care sites in three networks are randomized to one of four arms: (1) standard care, (2) "visit-based" reminders that appear in a patient's electronic health record (EHR) when it is accessed by either patient or providers (3) visit based reminders with population health outreach, and (4) visit based reminders, population health outreach, and patient navigation with systematic screening and referral to address social barriers to care. Eligible patients in participating practices are those overdue for follow-up of an abnormal results on breast, cervical, colorectal and lung cancer screening tests.
Results: The primary outcome is whether an individual receives follow-up, specific to the organ type and screening abnormality, within 120 days of becoming eligible for the trial. Secondary outcomes assess the effect of intervention components on the patient and provider experience of obtaining follow-up care and the delivery of the intervention components.
Conclusions: This trial will provide evidence for the role of a multilevel intervention on improving the follow-up of abnormal cancer screening test results. We will also specifically assess the relative impact of the components of the intervention, compared to standard care.
Trial Registration: ClinicalTrials.gov NCT03979495.
(Copyright © 2021. Published by Elsevier Inc.)
Databáze: MEDLINE
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