Member Adherence to a Health Insurer-Sponsored Gap Closure Program Using Multi-Target Stool DNA Test for Colorectal Cancer Screening.

IF 3 Q1 PRIMARY HEALTH CARE

Journal of Primary Care and Community Health Pub Date : 2024-01-01 DOI:10.1177/21501319241305958

Mallik Greene, Timo Pew, Quang Le, Alisdair Philp, William K Johnson, A Burak Ozbay, John Kisiel, Michael Dore, Derek Ebner, A Mark Fendrick, Paul Limburg

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引用次数: 0

Abstract

Objectives: To describe member adherence to a mail-based, health insurer-sponsored gap closure program for colorectal cancer (CRC) screening using multi-target stool DNA (mt-sDNA; Cologuard^®) tests.

Methods: Combined patient data from Exact Sciences Laboratories LLC and data from mass-mailed mt-sDNA orders placed by a large Medicare Advantage Insurance Plan were analyzed (03/01/2023-06/30/2023). Adherence and time to test return were the primary and secondary outcomes, respectively. Their association with patient characteristics was evaluated using multivariable regression.

Results: Among the 3201 member-patients included (86.6% aged 65-75 years; 58.7% female), adherence rate was 49.4%, and mean time to test return was 25.5 days. After multivariable adjustment, the odds of test return were significantly higher among 65- to 75-year-olds (odds ratio [OR] = 1.59 relative to 45- to 64-year-olds), those living in small towns (OR = 1.43 relative to metropolitan-located individuals), and with digital outreach via both SMS and email (OR = 4.31 relative to no digital outreach). Time to test return was shorter in 65- to 75-year-olds than in 45- to 64-year-olds and was not associated with other patient characteristics.

Conclusions: Mass-mailed mt-sDNA tests for CRC screening were associated with an overall adherence rate of about 50% in this Medicare Advantage population, with higher likelihood of test return among patients receiving digital outreach.

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成员坚持使用多靶点粪便DNA检测结肠直肠癌筛查的健康保险公司赞助的缺口关闭计划。

目的：描述会员对使用多靶点粪便DNA （mt-sDNA）进行结直肠癌（CRC）筛查的基于邮件的健康保险公司赞助的缺口关闭计划的依从性；Cologuard®)测试。方法：结合Exact Sciences Laboratories LLC的患者数据和大型医疗保险优势计划（Medicare Advantage Insurance Plan）大量邮寄的mt-sDNA订单数据（2023年3月1日至2023年6月30日）进行分析。依从性和测试返回时间分别是主要和次要结局。使用多变量回归评估其与患者特征的关联。结果：纳入的3201例成员患者中，年龄65 ~ 75岁的占86.6%；58.7%女性)，依从率为49.4%，平均检测返回时间为25.5天。多变量调整后，65- 75岁人群（相对于45- 64岁人群的比值比[OR] = 1.59）、小城镇人群（相对于大城市人群的比值比[OR] = 1.43）和通过短信和电子邮件进行数字宣传的人群（相对于没有数字宣传的人群，OR = 4.31）的测试返回率显著更高。65- 75岁患者的复诊时间比45- 64岁患者短，且与其他患者特征无关。结论：大量邮寄用于结直肠癌筛查的mt-sDNA检测与医疗保险优势人群中约50%的总体依从率相关，在接受数字外展的患者中，测试返回的可能性更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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