RT Journal Article
SR Electronic
T1 Colorectal Cancer Screening Rates Increased after Exposure to the Patient-Centered Medical Home (PCMH)
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 191
OP 200
DO 10.3122/jabfm.2016.02.150290
VO 29
IS 2
A1 Beverly B. Green
A1 Melissa L. Anderson
A1 Jessica Chubak
A1 Laura Mae Baldwin
A1 Leah Tuzzio
A1 Sheryl Catz
A1 Alison Cole
A1 Sally W. Vernon
YR 2016
UL http://www.jabfm.org/content/29/2/191.abstract
AB Objective: The patient-centered medical home (PCMH) includes comprehensive chronic illness and preventive services, including identifying patients who are overdue for colorectal cancer screening (CRCS). The association between PCMH implementation and CRCS during the Systems of Support to Increase Colorectal Cancer Screening Trial (SOS) is described.Methods: The SOS enrolled 4664 patients from 21 clinics from August 2008 to November 2009. Patients were randomized to usual care, mailed fecal kits, kits plus brief assistance, or kits plus assistance and navigation. A PCMH model that included a workflow for facilitating CRCS was implemented at all study clinics in late 2009. Patients enrolled early had little exposure to the PCMH, whereas patients enrolled later were exposed during most of their first year in the trial. Logistic regression models were used to assess the association between PCMH exposure and CRCS.Results: Usual care patients with ≥8 months in the PCMH had higher CRCS rates than those with ≤4 months in the PCMH (adjusted difference, 10.1%; 95% confidence interval, 5.7–14.6). SOS interventions led to significant increases in CRCS, but the magnitude of effect was attenuated by exposure to the PCMH (P for interaction = .01).Conclusion: Exposure to a PCMH was associated with higher CRCS rates. Automated mailed and centrally delivered stepped interventions increased CRCS rates, even in the presence of a PCMH.