通过实践促进和学术详述提高初级保健中的癌症筛查率:多PBRN质量改进项目。

IF 1.6 Q3 HEALTH CARE SCIENCES & SERVICES
Journal of Patient-Centered Research and Reviews Pub Date : 2021-10-18 eCollection Date: 2021-01-01 DOI:10.17294/2330-0698.1855
Christopher P Morley, Laura A Schad, Laurene M Tumiel-Berhalter, Laura A Brady, Alexandrea Bentham, Karen Vitale, Amanda Norton, Gary Noronha, Carlos Swanger
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引用次数: 0

摘要

目的:在美国,癌症筛查率往往低于国家目标。该项目实施了实践促进和学术细化,旨在提高安全网初级保健实践中的乳腺癌、宫颈癌和结直肠癌筛查率:方法:纽约州西部和中部的三个基于实践的研究网络合作提供乳腺癌、宫颈癌和结直肠癌筛查的质量改进策略。每年收集所有参与实践的干预前/后筛查率,以及所有实践在 7 年内的平均值。使用简单的普通最小二乘法线性回归计算每种癌症类型的趋势,并检验统计显著性(即 P≤0.05 ),将序时点作为固定效应:结果:在项目实施期间,大肠癌的平均筛查率总体有所提高(干预前为 24.6%,干预后第 7 年为 48.0%;PC 结论:实践促进和学术细化工作取得了显著成效:实践促进和学术细化成功地大幅提高了平均结直肠癌筛查率。宫颈癌筛查率总体上有所下降,这可能是由于初级保健实践在跟踪和实施方面遇到了困难,因为许多患者是在外面的妇科机构寻求这项服务的。地区差异、指南变化和实践重组都可能对观察到的趋势起到一定作用。要提高这些数据的可靠性,必须对筛查率的查询进行标准化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improving Cancer Screening Rates in Primary Care via Practice Facilitation and Academic Detailing: A Multi-PBRN Quality Improvement Project.

Purpose: In the United States, cancer screening rates are often below national targets. This project implemented practice facilitation and academic detailing aimed at increasing breast, cervical, and colorectal cancer screening rates in safety-net primary care practices.

Methods: Three practice-based research networks across western and central New York State partnered to provide quality improvement strategies on breast, cervical, and colorectal cancer screening. Pre/postintervention screening rates for all participating practices were collected annually, as were means across all practices over 7 years. Simple ordinary least squares linear regression was used to calculate the trend for each cancer type and test for statistical significance (ie, P≤0.05), using the ordinal time point as a fixed effect.

Results: An overall increase in mean screening rates was seen over the duration of this project for colorectal (24.6% preintervention to 48.0% in year 7 of intervention; P<0.001) and breast cancer (37.0% preintervention to 48.6% in year 7; P=0.460). Mean cervical cancer screening rates decreased (35.5% preintervention to 31.4% in year 7; P=0.209). Success in increasing screening rates varied across regions of New York State.

Conclusions: Practice facilitation and academic detailing were successful in significantly increasing, on average, colorectal cancer screening rate. Cervical cancer screening showed an overall decrease, likely due to difficulties for primary care practices in tracking and implementation, as many patients seek this service at outside gynecology facilities. Regional differences, guideline changes, and practice reorganization each may have played a part in observed trends. A standardization of queries being used to pull screening rates is an important step in increasing the reliability of these data.

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来源期刊
Journal of Patient-Centered Research and Reviews
Journal of Patient-Centered Research and Reviews HEALTH CARE SCIENCES & SERVICES-
自引率
5.90%
发文量
35
审稿时长
20 weeks
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