Compliance with mammography guidelines: Physician recommendation and patient adherence
Compliance with mammography guidelines: Physician recommendation and patient adherence
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DOI：
10.1006/pmed.1998.0443
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发表时间：
1999-04-01
影响因子：
5.1
通讯作者：
Fouad, MN
中科院分区：
文献类型：
--
作者：
May, DS;Kiefe, CI;Fouad, MN
背景指南建议50-75岁的女性每1-2年接受一次筛查性乳房X光检查。我们相关的医生建议接受乳房X光检查和患者遵守这些建议的几个病人的特点。我们回顾性分析了1,111名年龄在50-75岁之间的女性在一所城市大学医学中心的三个诊所就诊的病历。我们确定了对乳腺X线摄影指南的总体依从性和两个依从性组成部分：收到医生建议和遵守建议。结果指标是根据几个患者相关特征，显示每种依从性的患者比例和调整后的比值比。总体而言，66%的女性收到了推荐信。在收到书面建议的妇女中，75%的人遵守了建议。与接受推荐有显著正相关的因素包括：在普通内科诊所就诊，有私人保险，更经常地去诊所，最近做过巴氏涂片检查。患者依从性与私人保险和巴氏涂片检查史呈正相关，与内科负相关，与访问频率无关。结论，影响医生乳房X线检查建议的患者因素可能不同于与患者依从性相关的因素，除了有私人健康保险，这是两者的预测因素。(C)1999年美国健康基金会和学术出版社。
Background Guidelines recommend that women ages 50-75 years receive screening mammography every 1-2 years. We related receipt of physician recommendations for mammography and patient adherence to such recommendations to several patient characteristics.Methods. We retrospectively reviewed medical records of 1,111 women ages 50-75 attending three clinics in an urban university medical center. We ascertained overall compliance with mammography guidelines and two components of compliance: receipt of a physician recommendation and adherence to a recommendation. Outcome measures were the proportion of patients demonstrating each type of compliance and adjusted odds ratios, according to several patient-related characteristics.Results. Overall, 66% of women received a recommendation. Of women receiving a documented recommendation, 75% adhered. Factors showing significant positive associations with receiving a recommendation included being a patient in the general internal medicine clinic, having private insurance, visiting the clinic more often, and having a recent Pap smear. Patient adherence was positively associated with private insurance and Pap smear history, negatively associated with internal medicine, and not associated with visit frequency.Conclusions, Patient factors influencing physician mammography recommendations may be different from those associated with patient adherence, except for having private health insurance, which was a predictor of both. (C) 1999 American Health Foundation and Academic Press.