Enhancing compliance with screening mammography recommendations: a clinical trial in a primary care office.
OBJECTIVE
Despite consensus that screening mammography is an appropriate preventive tool, many women do not receive this examination. This study was undertaken to evaluate the relative efficacy and cost-effectiveness of three interventions designed to increase mammography rates.


METHODS
A total of 151 women, aged 50-59, were randomized into four groups: control, physician telephone call, medical assistant telephone call, and physician letter.


RESULTS
The women in the medical assistant telephone call group (16 of 37 = 43%) and the physician telephone call group (11 of 38 = 29%) responded significantly better than those in the control group (4 of 38 = 11%) (P < .05). None of the 10 widows in the entire study obtained a mammogram, compared with 38 of 141 (27%) women in all other marital groups (P < .05). The cost per intervention and cost per mammogram obtained were, respectively, physician telephone call: $15, $51.82; physician letter: $2.50, $13.57; medical assistant call: $1.30, $3.


CONCLUSIONS
Medical assistant telephone callers are a cost-effective strategy to encourage mammography adherence. Widows appear particularly resistant to all screening mammography interventions.
Mohler
P J
PJ
Family Physicians of Western Colorado, Grand Junction, USA.
D001071:Appointments and Schedules; D015709:Correspondence as Topic; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008327:Mammography / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D010349:Patient Compliance; D010818:Practice Patterns, Physicians'; D017010:Reminder Systems / Q000191:economics; D013689:Telephone