Communication factors in the follow-up of abnormal mammograms.
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.
Poon
Eric G
EG
Department of Medicine, Brigham and Women's Hospital, Harvard School of Public Health, Boston, Massachusetts 02115, USA. epoon@partners.org
Haas
Jennifer S
JS
Louise Puopolo
Ann
A
Gandhi
Tejal K
TK
Burdick
Elisabeth
E
Bates
David W
DW
Brennan
Troyen A
TA
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