Improving mammography screening using best practices and practice enhancement assistants: an Oklahoma Physicians Resource/Research Network (OKPRN) study.
OBJECTIVE
In 2004 only 68% of women in Oklahoma over the age of 40 reported having a mammogram in the past 2 years, compared with 75% nationally. Strategies to improve mammography rates have been numerous but have generally included single strategies, such as physician education, practice audit and feedback, and reminders; flow sheets and results have been mixed. The purpose of this randomized controlled trial was to determine the impact of a practice facilitator and "best practice" interventions on mammography rates in a practice-based research network.


METHODS
A total of 16 practices participated; 8 were assigned to intervention and 8 to usual care. Pre- and post-audits of mammography rates were conducted. Intervention practices received feedback with benchmarking, academic detailing, and the assistance of a practice enhancement assistant to help with practice redesign over a 9-month period.


RESULTS
The groups differed significantly for both the proportion of mammograms offered to eligible patients (P = .043) and for the proportion of patients with current mammograms (P < .015). For the control group, 38% of eligible women were offered a mammogram and 202 (35% of those eligible) actually did have documentation that a mammogram had been performed. Fifty-three percent of the eligible patients in the intervention group were offered a mammogram and 52% of those eligible (n = 332) did have documentation in the chart that the mammogram had been completed.


CONCLUSIONS
The results suggest that these interventions can improve mammography rates in a range of practice settings. These findings are consistent with other studies that have tested multicomponent interventions.
Aspy
Cheryl B
CB
Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. cheryl-aspy@ouhsc.edu
Enright
Margaret
M
Halstead
Lawanna
L
Mold
James W
JW
D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008327:Mammography / Q000639:trends*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009825:Oklahoma; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011320:Primary Health Care / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results