Fox S, Stockdale S, DiMatteo MR, Asch S, Reise SP, Heritage J; AcademyHealth. Meeting (2003 : Nashville, Tenn.).

Abstr AcademyHealth Meet. 2003; 20: abstract no. 168.

University of California @ Los Angeles, Medicine, 1100 Glendon Ave, Ste 2010, Los Angeles, CA 90024 Tel. (310) 794-8500 Fax (310) 794-8529

RESEARCH OBJECTIVE: Physicians have been shown to be influential in affecting patient behaviors such as stopping smoking but their impact on the cancer screening of their patients is unknown. Studies to date have focused on patients to improve cancer screening rates while efforts to maximize screening through physicians have been neglected. Our primary objective was to examine the effects of physician-patient communication on cancer screening rates and to develop a model of effective physician-patient communication about cancer screening that can be applied in the community to improve screening rates. STUDY DESIGN: Hypothesis-testing physician-patient cohort study. POPULATION STUDIED: 63 primary care physicians and 904 of their female patients over age 50 enrolled as a consecutive sample and based in Los Angeles County. PRINCIPAL FINDINGS: Using a multilevel analysis to account for patients nested by physicians, patient's rating of physician's enthusiasm (extremely or very enthusiastic discussion vs. moderate to not all enthusiastic) for mammography was a strong predictor of adherence (OR=2.046,p<.05). In addition, any discussion of fecal occult blood test(FOBT) screening, no matter the level of enthusiasm, resulted in higher odds of screening (OR=7.344,p<.05). For mammography, our model predicts an increase in screening from an observed rate of 83% to 89% that is possible if all women experienced a high level of enthusiasm for mammography from their physicians. The results were more dramatic for FOBT, with a predicted increase in screening from 31% to 58% if all women experienced a high level of enthusiasm for FOT form their physicians. Due to the low recruitment rate (45%) for the physicians, we conducted a sensitivity analysis to determine if our sample was comparable to the population of Los Angeles County physicians. Results show that the effects of patient's perception of physician enthusiasm for screening are robust and representative. CONCLUSIONS: When patients perceive that their physicians are enthusiastic about cancer screening, they are significantly more likely to get mammograms and FOBT. However, for FOBT screening, even if the physicians just discuss screening with patients without enthusiasm, patients are significantly more likely to get screened. In focus groups with patients, an enthusiastic physician was defined as a caring professional who reminded patients to get screening and/or asked about their concerns and/or stressed the importance of screening and/or educated patients about screening. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: All or any of these modest communication topics are easily incorporated into a typical physician-patient communication, and should be if screening rates in the community are to be enhanced. These communication strategies can be employed in all types of practice settings without requiring lengthy discussion.

Publication Types:

• Meeting Abstracts

Keywords:

• Cohort Studies
• Communication
• Female
• Humans
• Los Angeles
• Mammography
• Mass Screening
• Physicians
• Physicians, Family
• Risk Management
• economics
• radiography
• hsrmtgs

Other ID:

• GWHSR0003474

UI: 102275153

From Meeting Abstracts