Improving Compliance With Medical Testing Guidelines
Study Details
Study Description
Brief Summary
The study hypothesis is that clearer visual presentation of guideline recommendations and educational outreach, or academic detailing, can improve guideline compliance. However, it will investigate other aspects of screening-related decision-making, such as provider and patient beliefs about screening, provider-patient communication and patient's willingness to forgo expected testing. The research question is whether educational interventions can decrease non-compliance with screening guidelines for 5 common cancers.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
This study is a cluster randomized trial that compares the immediate post-encounter impressions of 12 physicians and 18 of their patients about the discussion of screening for breast, cervical, colorectal, lung and prostate cancer as well as their beliefs about screening efficacy and patient reports of the screening experience. The interventions are educational materials and academic detailing (educational outreach) for providers. The investigators are particularly interested in contrasting the patient and provider recollections, the differential impact on underuse and overuse compliance and whether patient behaviors are consistent with their stated screening plans.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: Standard Support Outreach Providers receive standard written screening recommendations and do not receive academic detailing (educational outreach) |
Other: Standard support
Screening recommendations presented in standard format
Other: No academic detailing
Physician receives study orientation for not the academic detailing curriculum
|
| Experimental: Standard materials and academic detailing Providers receive standard written screening recommendations and receive academic detailing (educational outreach) |
Other: Academic detailing
Educational outreach to address the rationale and data supporting recommendations for and against screening
Other: Standard support
Screening recommendations presented in standard format
|
| Experimental: Color-coded materials and no academic detailing Providers receive color-coded written screening recommendations and do not receive academic detailing (educational outreach) |
Other: Color-coded materials
A summary of treatment recommendations for each cancer screening is color-coded to indicate the strength and direction of the recommendation
Other: No academic detailing
Physician receives study orientation for not the academic detailing curriculum
|
| Experimental: Color-coded materials and academic detailing Providers receive color-coded written screening recommendations and receive academic detailing (educational outreach) |
Other: Color-coded materials
A summary of treatment recommendations for each cancer screening is color-coded to indicate the strength and direction of the recommendation
Other: Academic detailing
Educational outreach to address the rationale and data supporting recommendations for and against screening
|
Outcome Measures
Primary Outcome Measures
- Effect of educational intervention on providers' recommendations [Baseline]
Incidence of guidance compliance
- Effect of educational intervention on providers' recommendations [3 months]
Incidence of guidance compliance
- Effect of educational intervention on providers' recommendations [6 months]
Incidence of guidance compliance
- Effect of educational intervention on providers' recommendations [12 months]
Incidence of guidance compliance
Secondary Outcome Measures
- Patients' belief in the value of screening [Baseline]
measured by survey to be determined
- Patients' belief in the value of screening [3 months]
measured by survey to be determined
- Patients' belief in the value of screening [6 months]
measured by survey to be determined
- Patients' belief in the value of screening [12 months]
measured by survey to be determined
- Patient compliance [Baseline]
measured by self- report in surveys to be determined
- Patient compliance [3 months]
measured by self- report in surveys to be determined
- Patient compliance [6 months]
measured by self- report in surveys to be determined
- Patient compliance [12 months]
measured by self- report in surveys to be determined
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Patients: healthy men and women ages 30-89 seeing their primary care provider for routine visit
-
Providers: non-pediatric primary care physicians from Mount Sinai Beth Israel or St. Luke's-Roosevelt associated practices
Exclusion Criteria:
-
Patient life expectancy of less than 1 year in primary care provider's judgment
-
Inability to read and understand English
-
Transgender status
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Mount Sinai Beth Israel | New York | New York | United States | 10003 |
| 2 | St. Luke's-Roosevelt | New York | New York | United States | 10019 |
Sponsors and Collaborators
- Beth Israel Medical Center
Investigators
- Principal Investigator: James A Talcott, MD SM, Mount Sinai Beth Israel
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- OGARA CAN-264