A patient recall program to enhance decisions about prostate cancer screening: a feasibility study.
BACKGROUND
Lack of time and competing demands limit the ability of patients and providers to engage in informed decision-making discussions about prostate cancer screening during primary care visits. We evaluated a patient recall intervention to mitigate these challenges.


METHODS
Using mail and telephone outreach we invited men age 50-74 years without a PSA test in the prior 12 months to make appointments with their primary care providers in order to discuss the pros and cons of PSA-based prostate cancer screening. We assessed patient responsiveness to the program, provider documentation of screening discussions, orders for PSA laboratories, and provider attitudes.


RESULTS
Out of 80 eligible patients, 37 (46%) scheduled and 28 (35%) completed a recall appointment. A large majority (91%) of patients eligible for PSA screening received an order for this test. Providers documented PSA discussions more often for these patients than for a recent sample of their other patients who received traditional care (47.8% vs. 12.5%, p = 0.009). Twelve of 14 participating providers felt the program improved their ability to impart information about the risks and benefits of screening, but were uncertain whether it influenced their patients' preexisting preferences for screening. Some expressed doubts about the advisability of PSA-specific appointments.


CONCLUSIONS
To a limited extent, this pilot recall intervention enhanced opportunities for discussions of prostate cancer screening between patients and their primary care providers. As currently configured, however, this program was not found to be feasible for this purpose. A future version should promote screening discussions in the context of a broader range of health maintenance concerns and include more detailed, low-literacy information to educate patients in advance of clinic visits.
Denberg
Thomas D
TD
Department of Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USA. tom.denberg@uchsc.edu
Bhide
Manisha
M
Soenksen
Alyssa
A
Mizrahi
Trina
T
Shields
Laura
L
Lin
Chen-Tan
CT
D000368:Aged; D001071:Appointments and Schedules; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003142:Communication; D003657:Decision Making; D055088:Early Detection of Cancer / Q000523:psychology*; D005240:Feasibility Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D010358:Patient Participation; D010817:Physician-Patient Relations; D011320:Primary Health Care; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000517:prevention & control
D017430:Prostate-Specific Antigen