Mammogram referral, screening rates boosted with point-of-care screening program

PHILADELPHIA – Mammogram referral and screening rates in a point-of-care breast cancer screening project were significantly improved, compared with those rates in conventional practice, researchers reported at the American Association of Nurse Practitioners (AANP) 2017 National Conference.

Jill Muhrer, DNP, FNP-BC, of the Urban Health Institute in Camden, NJ, and colleagues sought to increase mammogram referral and screening rates with use of the evidence-based Point-of-Care Integrated Breast Cancer Screening Model (PCISM). The program aimed to provide effective point-of-care referrals for breast cancer screening in a federally qualified health center.

In 2013, 65.9% of eligible women had completed a mammogram within 2 years, Dr Muhrer noted. Mammogram rates are lowest among low-income, uninsured women; racial and ethnic minorities; and women who do not have a primary care provider.

“While these factors create barriers to screening, the primary reason that women cite for not obtaining mammograms is lack of provider recommendations,” Dr Muhrer stated. “One solution to bridging the gap between evidence-based recommendations and clinical practice is to offer mammograms to patients at all patient appointments, regardless of the reason for the visit.” 

After implementation of the PCISM, the researchers observed improvements in breast cancer screening rates. A comparison of mammogram patterns for 8 providers (classified according to their use of PCISM versus conventional practice models) showed a statistically significant difference, according to Dr Muhrer’s group. In the PCISM group, 2451 women (43%) were referred and 2444 women (42%) completed mammograms. Within the conventional practice group, 1409 women (37%) received referrals and 581 (16%) had a mammogram.

“The findings of this small program evaluation suggest that the use of PCISM can improve mammography referral and screening rates in federally qualified health centers, and in doing so, can translate evidence-based recommendations into preventive clinical practices that can ultimately save lives through early detection and treatment,” the researchers concluded. “The PCISM could also be implemented with different types of cancer screening and ultimately generalized to other practice settings.

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Reference

1. Muhrer J. Breast cancer referral and screening rates in a federally qualified health center: implementing the Point of Care Integrated Breast Cancer Screening Model. Presented at the American Association of Nurse Practitioners 2017 National Conference; June 20-25, 2017; Philadelphia.