Reminders Help Patients Get Better Care

Simple interventions boosted colon cancer screening rates, researchers say

Posted: February 23, 2009

MONDAY, Feb. 23 (HealthDay News) -- A little information and guidance can prompt patients to play a much greater role in improving their own health care, a new study focused on colon cancer screening suggests.

The 15-month Harvard study included 21,860 patients, ages 50 to 80, who were overdue for colorectal cancer screenings.

One group of patients received the usual care. A second group received a mailed, personalized letter outlining their history of colon cancer screening exams, information about colon cancer, a fecal occult blood test kit, and instructions for scheduling either a colonoscopy or sigmoidoscopy.

The study found that 44 percent of patients in the second group got screened for colorectal cancer, compared with 38 percent of those in the first group. The older they were, the more likely patients in the second group were to get screened -- among those ages 70 to 80, screening rates increased from 37 percent to 47 percent.

The study also included 110 primary care doctors. Some were selected to receive electronic reminders that their patients were overdue for colorectal cancer screening. Overall, 42 percent of patients whose doctors received the electronic reminders got screened, compared to 40 percent of patients whose doctors didn't get reminders.

This negligible difference may be due to the fact that up to one third of patients didn't visit their primary care doctor during the study, said the researchers.

Among patients who saw their doctor frequently, screening rates were 60 percent for those whose doctors received reminders and 52 percent for those whose doctors didn't get reminders.

The study appears in the Feb. 23 issue of the journal Archives of Internal Medicine.

"We had a large group of people who needed to be screened for a very important condition. If we provided them with basic information about colon cancer and their need for screening, this approach was more effective than simply leaving it all up to the doctor," study co-author John Ayanian, a professor of medicine and health care policy at Harvard Medical School, said in a news release.

The findings show "that patients can take a more active role in their health care. We often don't give enough credit to patients for their ability to own their own health care. But here's some evidence that patients can better manage their health care if we arm them with the right information," study co-author Thomas Sequist, an assistant professor of medicine and of health care policy at Harvard Medical School and Brigham and Women's Hospital, said in the release.

More information

The American Academy of Family Physicians outlines measures patients can take to protect their health.

Death by Colonoscopy

My name is Konstantin Monastyrsky. I am a medical writer and an expert in forensic nutrition. I recently released an investigative report entitled “Death By Colonoscopy” on YouTube and my website. This report is based entirely on mainstream medical research, and is fully referenced (http://www.gutsense.org/crc/crc_transcript.html)

I realize the title of my report sounds bizarre, but before you label me insane, consider the following well-established facts:

-- Colonoscopy screening increases mortality from all other causes, research shows. The Telemark Polyp Study I demonstrated a 57% increase in mortality among screened patients vis-à-vis unscreened controls. The decrease in the incidence of colorectal cancers was only… 2%, which, statistically speaking, is below the margin of error.

-- According to the CDC (Centers for Disease Control and Prevention), since screening colonoscopies started in earnest in 2000, the annual incidence of colorectal cancers has grown by 30,000 new cases, while the mortality rate remained practically unchanged.

-- Estimated 55,000 Americans die annually from colon cancer. According to the report entitled “Complications of Colonoscopy in an Integrated Health Care Delivery System” by the Annals of Internal Medicine, an estimated 70,000 (0.5% from 14 million+ screenings) are killed or injured by colonoscopy-related complications. This figure is higher than the total number of annual deaths from colon cancer by 22%.

-- The 18 years long Minnesota Colon Cancer Control Study included 46 plus thousand patients between the ages of 50 and 80. It demonstrated only a 0.6% reduction in the incidence of colorectal cancer. Statistically speaking, this difference is even less than the chance outcome of one thousand coin flips.

-- According to the Federal Drug Administration, X-ray exposure from a single virtual colonoscopy increases one’s lifetime risk of cancer by 20%. Virtual colonoscopies are now recommended every 5 years. By age 70 one’s risk of developing any other form of cancer grows to 100%. Killing you with another form of cancer before the colon gets affected is one hell-of-the-way to “prevent” colon cancer.

www.GutSense.org

P.S. If you have any questions related to my report, feel free to contact me by e-mail via my site.

GutSense of NJ @ Feb 24, 2009 23:02:50 PM

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