title: Communication factors in the follow-up of abnormal mammograms.
abstract: OBJECTIVE
  To identify the communication factors that are significantly associated with appropriate short-term follow-up of abnormal mammograms.
  
  
  METHODS
  Prospective longitudinal study involving medical record review and patient survey.
  
  
  METHODS
  Ten academically affiliated ambulatory medical practices in the Boston metropolitan area.
  
  
  METHODS
  One hundred twenty-six women with abnormal mammograms requiring short-term (6 months) follow-up imaging.
  
  
  METHODS
  Proportion of women in the study who received appropriate follow-up care.
  
  
  RESULTS
  Eighty-one (64%) of the women with abnormal mammograms requiring short-term follow-up imaging received the appropriate follow-up care. After adjusting for patients' age and insurance status, 2 communication factors were found to be independently associated with the delivery of appropriate follow-up care: 1). physicians' documentation of a follow-up plan in the medical record (adjusted odds ratio, 2.79; 95% confidence interval, 1.11 to 6.98; P =.029); and 2). patients' understanding of the need for follow-up (adjusted odds ratio, 3.86; 95% confidence interval, 1.50 to 9.96; P =.006). None of the patients' clinical or psychological characteristics were associated with the delivery of appropriate follow-up care.
  
  
  CONCLUSIONS
  Follow-up care for women with abnormal mammograms requiring short-term follow-up imaging is suboptimal. Documentation of the follow-up plan by the physician and understanding of the follow-up plan by the patient are important factors that are correlated with the receipt of appropriate follow-up care for these women. Interventions designed to improve the quality of result follow-up in the outpatient setting should address these issues in patient-doctor communication.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Harvard School of Public Health, Boston, Massachusetts 02115, USA. epoon@partners.org
authors.forename: Eric G
authors.initials: EG
authors.lastname: Poon
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Haas
authors.forename: Ann
authors.initials: A
authors.lastname: Louise Puopolo
authors.forename: Tejal K
authors.initials: TK
authors.lastname: Gandhi
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Burdick
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
authors.forename: Troyen A
authors.initials: TA
authors.lastname: Brennan
mesh_terms: D001941:Breast Diseases / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging; D003142:Communication; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D008327:Mammography; D008875:Middle Aged; D010817:Physician-Patient Relations; D011320:Primary Health Care; D011446:Prospective Studies; D011787:Quality of Health Care