Provider-perceived barriers to patient adherence to colorectal cancer screening
Background: Average-risk colorectal cancer (CRC) screening remains underutilized in the US. Provider recommendation is strongly associated with CRC screening completion. To inform interventions aimed at improving screening uptake, we examined providers’ perspectives on patient and health system barr...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-02-01
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| Series: | Preventive Medicine Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335521003727 |
| _version_ | 1818952488349335552 |
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| author | Xuan Zhu Emily Weiser Debra J. Jacobson Joan M. Griffin Paul J. Limburg Lila J. Finney Rutten |
| author_facet | Xuan Zhu Emily Weiser Debra J. Jacobson Joan M. Griffin Paul J. Limburg Lila J. Finney Rutten |
| author_sort | Xuan Zhu |
| collection | DOAJ |
| description | Background: Average-risk colorectal cancer (CRC) screening remains underutilized in the US. Provider recommendation is strongly associated with CRC screening completion. To inform interventions aimed at improving screening uptake, we examined providers’ perspectives on patient and health system barriers to CRC screening adherence, along with associated system-level interventions to improve uptake. Methods: We conducted an online survey between November and December 2019 with a sample of primary care clinicians (PCCs) and gastroenterologists (GIs) from a validated panel of US clinicians (814 PCCs, 159 GIs; completion rates: 25.3% for PCCs, 29.6% for GIs). Clinicians rated the extent to which each patient and health system factor interferes with patient adherence with CRC screening recommendations and the availability of practice interventions to improve screening rates. Results: Provider-reported top barriers to CRC screening included patient discomfort with offered screening method (66%), cost (62–64%), and perceived low importance of screening (62%). Additional barriers included providers prioritizing urgent health concerns over screening (45–48%), not offering a choice of screening options (42–48%), lacking time to educate patients about screening (38–45%), and lacking education about available screening options (37–40%). Most frequently reported system-level interventions to improve CRC screening rates included patient education materials (57–62%) and point of care prompts (56–61%). Other interventions were less frequently reported, although variations existed by clinical specialty regarding barriers and interventions. Conclusions: Addressing barriers to CRC screening requires system-level interventions, including provider training on shared decision-making, automated scheduling and reminder processes, and policies to increase clinician time for preventive screening consultations. |
| first_indexed | 2024-12-20T09:51:10Z |
| format | Article |
| id | doaj.art-9a9faf35142e4db787b9196ccae691c4 |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-12-20T09:51:10Z |
| publishDate | 2022-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-9a9faf35142e4db787b9196ccae691c42022-12-21T19:44:35ZengElsevierPreventive Medicine Reports2211-33552022-02-0125101681Provider-perceived barriers to patient adherence to colorectal cancer screeningXuan Zhu0Emily Weiser1Debra J. Jacobson2Joan M. Griffin3Paul J. Limburg4Lila J. Finney Rutten5Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Rochester, MN, USAExact Sciences Corporation, Madison, WI, USA; Corresponding author.Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USAMayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Rochester, MN, USA; Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USADivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USADivision of Epidemiology, Mayo Clinic, Rochester, MN, USABackground: Average-risk colorectal cancer (CRC) screening remains underutilized in the US. Provider recommendation is strongly associated with CRC screening completion. To inform interventions aimed at improving screening uptake, we examined providers’ perspectives on patient and health system barriers to CRC screening adherence, along with associated system-level interventions to improve uptake. Methods: We conducted an online survey between November and December 2019 with a sample of primary care clinicians (PCCs) and gastroenterologists (GIs) from a validated panel of US clinicians (814 PCCs, 159 GIs; completion rates: 25.3% for PCCs, 29.6% for GIs). Clinicians rated the extent to which each patient and health system factor interferes with patient adherence with CRC screening recommendations and the availability of practice interventions to improve screening rates. Results: Provider-reported top barriers to CRC screening included patient discomfort with offered screening method (66%), cost (62–64%), and perceived low importance of screening (62%). Additional barriers included providers prioritizing urgent health concerns over screening (45–48%), not offering a choice of screening options (42–48%), lacking time to educate patients about screening (38–45%), and lacking education about available screening options (37–40%). Most frequently reported system-level interventions to improve CRC screening rates included patient education materials (57–62%) and point of care prompts (56–61%). Other interventions were less frequently reported, although variations existed by clinical specialty regarding barriers and interventions. Conclusions: Addressing barriers to CRC screening requires system-level interventions, including provider training on shared decision-making, automated scheduling and reminder processes, and policies to increase clinician time for preventive screening consultations.http://www.sciencedirect.com/science/article/pii/S2211335521003727Colorectal cancer screeningProvider recommendationsPatient adherenceSystem-level intervention |
| spellingShingle | Xuan Zhu Emily Weiser Debra J. Jacobson Joan M. Griffin Paul J. Limburg Lila J. Finney Rutten Provider-perceived barriers to patient adherence to colorectal cancer screening Preventive Medicine Reports Colorectal cancer screening Provider recommendations Patient adherence System-level intervention |
| title | Provider-perceived barriers to patient adherence to colorectal cancer screening |
| title_full | Provider-perceived barriers to patient adherence to colorectal cancer screening |
| title_fullStr | Provider-perceived barriers to patient adherence to colorectal cancer screening |
| title_full_unstemmed | Provider-perceived barriers to patient adherence to colorectal cancer screening |
| title_short | Provider-perceived barriers to patient adherence to colorectal cancer screening |
| title_sort | provider perceived barriers to patient adherence to colorectal cancer screening |
| topic | Colorectal cancer screening Provider recommendations Patient adherence System-level intervention |
| url | http://www.sciencedirect.com/science/article/pii/S2211335521003727 |
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