Barbara J. Turner, MD, MSEd; Mark Weiner, MD; Chuya Yang, MS; Thomas TenHave, PhD
Presented at the 25th Annual Meeting of the Society of General Internal Medicine, Atlanta, Georgia, 2–4 May 2002.
Requests for Single Reprints: Barbara J. Turner, MD, MSEd, University of Pennsylvania, 1123 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104; e-mail, firstname.lastname@example.org.
Potential Financial Conflicts of Interest: None disclosed.
Current Author Addresses: Dr. Turner: University of Pennsylvania, 1123 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104.
Drs. Weiner and TenHave: University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104.
Ms. Yang: University of Pennsylvania, 1135 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104.
Author Contributions: Conception and design: B.J. Turner, M. Weiner.
Analysis and interpretation of the data: B.J. Turner, M. Weiner, T. TenHave.
Drafting of the article: B.J. Turner.
Critical revision of the article for important intellectual content: B.J. Turner, M. Weiner, T. TenHave.
Final approval of the article: B.J. Turner, M. Weiner, T. TenHave, C. Yang.
Provision of study materials or patients: M. Weiner.
Statistical expertise: T. TenHave.
Administrative, technical, or logistic support: M. Weiner,
Collection and assembly of data: M. Weiner, C. Yang.
Poor patient attendance to scheduled flexible sigmoidoscopy or colonoscopy may contribute to deficient colorectal cancer screening.
To examine the association of physician appointment-keeping behavior with attendance to scheduled endoscopic studies of the colon.
23 sites performing endoscopic procedures in a health care system.
11 803 patients scheduled for a first colon study with 3 or more scheduled physician visits from June 1999 through November 2001.
2 outcomes from health system computerized records: 1) attendance at the first scheduled colon study and 2) among nonattendees, attendance at the study rescheduled within 6 months. Physician visit adherence was defined as the proportion of physician visits kept, grouped by quartile. Adjusted associations were examined in conditional logistic regression.
Of 11 803 patients, 62% attended the first colon study. Of the 4496 nonattendees, 2739 (61%) rescheduled and, of these, 64% kept that appointment. Compared with the highest quartile of physician visit adherence (>85%), the adjusted odds ratio of attending the first colon study decreased as physician visit adherence decreased: Adjusted odds ratios were 0.94 (95% CI, 0.89 to 1.00) for 76% to 85% adherence, 0.87 (CI, 0.81 to 0.92) for 66% to 75% adherence, and 0.79 (CI, 0.73 to 0.85) for adherence of 65% or less. Among nonattendees who rescheduled, the lowest quartile of physician visit adherence (≤ 65%) was the only statistically significant predictor of attending the rescheduled study (adjusted odds ratio, 0.87 [CI, 0.78 to 0.98]).
The adherence measure applies only to patients with at least 3 scheduled visits. Persons having a colon study outside of the system could have been misclassified.
Physician appointment-keeping behavior predicted attendance to colorectal endoscopic studies in this cohort and may help identify persons who need interventions to promote adherence.
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Turner BJ, Weiner M, Yang C, TenHave T. Predicting Adherence to Colonoscopy or Flexible Sigmoidoscopy on the Basis of Physician Appointment–Keeping Behavior. Ann Intern Med. 2004;140:528-532. doi: 10.7326/0003-4819-140-7-200404060-00013
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Published: Ann Intern Med. 2004;140(7):528-532.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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