Primary Care Practitioner Perceptions on the Follow-up of Abnormal Cancer Screening Test Results.

Autor:	Atlas SJ; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Tosteson ANA; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, New Hampshire.; Dartmouth Cancer Center, Dartmouth Health and Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire., Burdick TE; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, New Hampshire.; Department of Community and Family Medicine, Dartmouth Health, Lebanon, New Hampshire., Wright A; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee., Breslau ES; Division of Cancer Prevention and Control, National Cancer Institute, Rockville, Maryland., Dang TH; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Wint AJ; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Smith RE; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, New Hampshire., Harris KA; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Zhou L; Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts., Haas JS; Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2022 Sep 01; Vol. 5 (9), pp. e2234194. Date of Electronic Publication: 2022 Sep 01.
DOI:	10.1001/jamanetworkopen.2022.34194
Abstrakt:	Importance: Health care systems focus on delivering routine cancer screening to eligible individuals, yet little is known about the perceptions of primary care practitioners (PCPs) about barriers to timely follow-up of abnormal results. Objective: To describe PCP perceptions about factors associated with the follow-up of abnormal breast, cervical, colorectal, and lung cancer screening test results. Design, Setting, and Participants: Survey study of PCPs from 3 primary care practice networks in New England between February and October 2020, prior to participating in a randomized clinical trial to improve follow-up of abnormal cancer screening test results. Participants were physicians and advanced practice clinicians from participating practices. Main Outcomes and Measures: Self-reported process, attitudes, knowledge, and satisfaction about the follow-up of abnormal cancer screening test results. Results: Overall, 275 (56.7%) PCPs completed the survey (range by site, 34.9%-71.9%) with more female PCPs (61.8% [170 of 275]) and general internists (73.1% [201 of 275]); overall, 28,7% (79 of 275) were aged 40 to 49 years. Most PCPs felt responsible for managing abnormal cancer screening test results with the specific cancer type being the best factor (range, 63.6% [175 of 275] for breast to 81.1% [223 of 275] for lung; P < .001). The PCPs reported limited support for following up on overdue abnormal cancer screening test results. Standard processes such as automated reports, reminder letters, or outreach workers were infrequently reported. Major barriers to follow-up of abnormal cancer screening test results across all cancer types included limited electronic health record tools (range, 28.5% [75 of 263]-36.5%[96 of 263]), whereas 50% of PCPs felt that there were major social barriers to receiving care for abnormal cancer screening test results for colorectal cancer. Fewer than half reported being very satisfied with the process of managing abnormal cancer screening test results, with satisfaction being greatest for breast cancer (46.9% [127 of 271]) and lowest for cervical (21.8% [59 of 271]) and lung cancer (22.4% [60 of 268]). Conclusions and Relevance: In this survey study of PCPs, important deficiencies in systems for managing abnormal cancer screening test results were reported. These findings suggest a need for comprehensive organ-agnostic systems to promote timely follow-up of abnormal cancer screening results using a primary care-focused approach across the range of cancer screening tests.
Databáze:	MEDLINE
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