title: Effect of provider and patient reminders, deployment of nurse practitioners, and financial incentives on cervical and breast cancer screening rates.
abstract: OBJECTIVE
  To evaluate the effect of the Provider and Patient Reminders in Ontario: Multi-Strategy Prevention Tools (P-PROMPT) reminder and recall system and pay-for-performance incentives on the delivery rates of cervical and breast cancer screening in primary care practices in Ontario, with or without deployment of nurse practitioners (NPs).
  
  
  METHODS
  Before-and-after comparisons of the time-appropriate delivery rates of cervical and breast cancer screening using the automated and NP-augmented strategies of the P-PROMPT reminder and recall system.
  
  
  METHODS
  Southwestern Ontario.
  
  
  METHODS
  A total of 232 physicians from 24 primary care network or family health network groups across 110 different sites eligible for pay-for-performance incentives.
  
  
  METHODS
  The P-PROMPT project combined pay-for-performance incentives with provider and patient reminders and deployment of NPs to enhance the delivery of preventive care services.
  
  
  METHODS
  The mean delivery rates at the practice level of time-appropriate mammograms and Papanicolaou tests completed within the previous 30 months.
  
  
  RESULTS
  Before-and-after comparisons of time-appropriate delivery rates (< 30 months) of cancer screening showed the rates of Pap tests and mammograms for eligible women significantly increased over a 1-year period by 6.3% (P < .001) and 5.3% (P < .001), respectively. The NP-augmented strategy achieved comparable rate increases to the automated strategy alone in the delivery rates of both services.
  
  
  CONCLUSIONS
  The use of provider and patient reminders and pay-for-performance incentives resulted in increases in the uptake of Pap tests and mammograms among eligible primary care patients over a 1-year period in family practices in Ontario.
authors.affiliation: Département de médecine de famille et de médecine d'urgence, Université de Montréal, CRCHUM, Hôtel-Dieu - Pavillon Vimont, local 3:230, 3840 St-Urbain, Montréal, QC H2W 1T8, Canada. janusz.kaczorowski@umontreal.ca
authors.forename: Janusz
authors.initials: J
authors.lastname: Kaczorowski
authors.forename: Stephen J C
authors.initials: SJ
authors.lastname: Hearps
authors.forename: Lynne
authors.initials: L
authors.lastname: Lohfeld
authors.forename: Ron
authors.initials: R
authors.lastname: Goeree
authors.forename: Faith
authors.initials: F
authors.lastname: Donald
authors.forename: Ken
authors.initials: K
authors.lastname: Burgess
authors.forename: Rolf J
authors.initials: RJ
authors.lastname: Sebaldt
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000191:economics; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008327:Mammography; D008875:Middle Aged; D009722:Nurse Practitioners / Q000706:statistics & numerical data; D009864:Ontario; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000191:economics; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012052:Reimbursement, Incentive; D017010:Reminder Systems / Q000191:economics; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears