• J Gen Intern Med · Apr 2004

    Multicenter Study

    Communication factors in the follow-up of abnormal mammograms.

    • Eric G Poon, Jennifer S Haas, Louise PuopoloAnnA, Tejal K Gandhi, Elisabeth Burdick, David W Bates, and Troyen A Brennan.
    • Department of Medicine, Brigham and Women's Hospital, Harvard School of Public Health, Boston, Massachusetts 02115, USA. epoon@partners.org
    • J Gen Intern Med. 2004 Apr 1; 19 (4): 316323316-23.

    ObjectiveTo identify the communication factors that are significantly associated with appropriate short-term follow-up of abnormal mammograms.DesignProspective longitudinal study involving medical record review and patient survey.SettingTen academically affiliated ambulatory medical practices in the Boston metropolitan area.ParticipantsOne hundred twenty-six women with abnormal mammograms requiring short-term (6 months) follow-up imaging.MeasurementsProportion of women in the study who received appropriate follow-up care.ResultsEighty-one (64%) of the women with abnormal mammograms requiring short-term follow-up imaging received the appropriate follow-up care. After adjusting for patients' age and insurance status, 2 communication factors were found to be independently associated with the delivery of appropriate follow-up care: 1). physicians' documentation of a follow-up plan in the medical record (adjusted odds ratio, 2.79; 95% confidence interval, 1.11 to 6.98; P =.029); and 2). patients' understanding of the need for follow-up (adjusted odds ratio, 3.86; 95% confidence interval, 1.50 to 9.96; P =.006). None of the patients' clinical or psychological characteristics were associated with the delivery of appropriate follow-up care.ConclusionsFollow-up care for women with abnormal mammograms requiring short-term follow-up imaging is suboptimal. Documentation of the follow-up plan by the physician and understanding of the follow-up plan by the patient are important factors that are correlated with the receipt of appropriate follow-up care for these women. Interventions designed to improve the quality of result follow-up in the outpatient setting should address these issues in patient-doctor communication.

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