Influence of provider discussion and specific recommendation on colorectal cancer screening uptake among U.S. adults
Influence of provider discussion and specific recommendation on colorectal cancer screening uptake among U.S. adults
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DOI：
10.1016/j.ypmed.2014.06.022
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发表时间：
2014-10-01
影响因子：
5.1
通讯作者：
Klabunde, Carrie N.
中科院分区：
文献类型：
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作者：
Laiyemo, Adeyinka O.;Adebogun, Akeem O.;Klabunde, Carrie N.
目标.目前尚不清楚提供者关于结直肠癌（CRC）筛查方式的建议是否会影响患者的依从性。我们评估了提供者与患者之间关于CRC筛查的沟通情况，有或没有关于患者依从筛查指南的特定筛查方式建议。我们使用了2007年健康信息全国趋势调查（HINTS），并确定了4283名年龄至少50岁的受访者，并回答了有关他们与护理提供者的沟通和CRC筛查的问题。我们将符合CRC筛查定义为1年内使用粪便潜血试验（FOBT），5年内使用乙状结肠镜检查，或10年内使用结肠镜检查。我们在所有分析中都使用了调查权重。3320名（76.2%）受访者讨论了CRC筛查。这些讨论中约有95%是与医生进行的。总体而言，2793（62.6%）受访者目前与CRC筛查，无论筛查方式。对筛查的讨论（OR = 8.83，95%CI：720-10.84）和医务人员对筛查方式提出具体建议而不是让患者自己决定（OR = 2.04，95%CI：1.54-2.68）与患者对CRC筛查指南的依从性相关。当提供者讨论选择并提出具体的筛查测试建议时，CRC筛查指南的依从性得到改善。(C)2014 Elsevier Inc. All rights reserved.
Objectives. It is unclear if provider recommendations regarding colorectal cancer (CRC) screening modalities affect patient compliance. We evaluated provider-patient communications about CRC screening with and without a specific screening modality recommendation on patient compliance with screening guidelines.Methods. We used the 2007 Health Information National Trends Survey (HINTS) and identified 4283 respondents who were at least 50 years of age and answered questions about their communication with their care providers and CRC screening uptake. We defined being compliant with CRC screening as the use of fecal occult blood testing (FOBT) within 1 year, sigmoidoscopy within 5 years, or colonoscopy within 10 years. We used survey weights in all analyses.Results. CRC screening discussions occurred with 3320 (76.2%) respondents. Approximately 95% of these discussions were with physicians. Overall, 2793 (62.6%) respondents were current with CRC screening regardless of the screening modality. Discussion about screening (odds ratio (OR) = 8.83; 95% confidence interval (CI): 720-10.84) and providers making a specific recommendation about screening modality rather than leaving it to the patient to decide (OR = 2.04; 95% Cl: 1.54-2.68) were associated with patient compliance with CRC screening guidelines.Conclusion. Compliance with CRC screening guidelines is improved when providers discuss options and make specific screening test recommendations. (C) 2014 Elsevier Inc. All rights reserved.