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Evaluation of a Physician Office-Based Toolkit to Increase the Use of Colorectal Cancer Testing in the Medicare Population

Anna Pittman Schenck, PhD1, Carrie Klabunde, PhD2, Michael Pignone, MD, MPH3, Nelson Gunter, MD, MPH4, Sharon Peacock, BA1, and Joshua Young, BS1. (1) Health Assessment Division, Medical Review of North Carolina, 100 Regency Forest Drive, Suite 200, Cary, NC 27511, 919 380-9860, aschenck@ncqio.sdps.org, (2) Applied Research Program, National Cancer Institute, EPN 4005; 6130 Executive Boulevard, Bethesda, MD 20892, (3) Division of General Internal Medicine, University of North Carolina, 5039 Old Clinic Building, UNC Hospital, Chapel Hill, NC 27599, (4) Carolina Medical Review, 250 Berryhill Road, Suite 101, Columbia, SC 29210

We targeted physicians in North and South Carolina with an intervention designed to increase use of colorectal cancer (CRC) screening for Medicare enrollees. Primary care physicians in selected counties were offered free office-based toolkits to promote their use of CRC tests (n=2009). Tools included: patient and physician educational materials; a stage of change based patient video; a manual system to identify patients who needed CRC tests; county-specific test rates; and, Medicare coverage and billing information. Physicians were encouraged to order free materials described in the toolkit or to reproduce materials they wanted using the CD-Rom included in the toolkit. Medicare claims were used to measure physician CRC test use rates. Increases in physician CRC test use were assessed comparing pre- and post-intervention testing rates for targeted and non-targeted physicians. Linear regression models were used to test the significance of changes in CRC test use associated with participation. Twelve percent of the targeted physicians ordered toolkits. Additional toolkits were mailed to randomly selected physicians until a total 380 tool kits were distributed. Physicians who ordered the toolkits and those who ordered materials from the toolkit had significantly greater increases in test use than physician who were mailed tool kits or were not targeted (p < 0.05). These results suggest that although physician response to an invitation for free CRC toolkits is low, office-based tool are effective in helping interested physicians increase their use of CRC tests.

Learning Objectives:

Keywords: Cancer Screening, Medicare

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Innovations for Older Adults' Health and Well-being

The 132nd Annual Meeting (November 6-10, 2004) of APHA