Care coordination compared with usual care had a 20.4% higher completion of surveillance colonoscopy in primary care patients at a large health system with high-risk adenoma, according to data from Digestive Disease Week.
“By employing a coordination care protocol, nonclinical patient navigators are effective in increasing the uptake of surveillance colonoscopy completion within 3.5 years of index colonoscopy and improve rates of surveillance colonoscopy order placement ,” Anthony Myint, MD, recent graduate from the UCLA Internal Medicine program, said during his virtual presentation. “Interestingly, among those patients who completed surveillance, mean time to completion was not significantly different between the two arms.”
Myint and colleagues identified 110 patients assigned to a UCLA primary care provider who were diagnosed with high-risk adenoma with a lack of documented surveillance. They assigned 53 patients to intervention with care coordination and 57 patients to usual care.
The care coordination process involved the PCP received an electronic notification with high-risk adenoma surveillance guideline information and an electronic colonoscopy order; patient received telephone call to discuss surveillance once PCP signed the colonoscopy order; and patient received call from the procedure scheduling center to schedule colonoscopy. The usual care group received no intervention. Investigators followed both treatment groups until the end of the follow-up period in October 2019. The uptake of surveillance colonoscopy within 3.5 years of the high-risk adenoma diagnosis was compared between the treatment groups. Additionally, they compared demographics, clinical characteristics and implementation process measures.
Results showed surveillance colonoscopy completion was higher in the intervention group compared with usual care (41.5% vs. 21.1%; P = .02). More colonoscopies were ordered in the intervention group compared with the usual care group (92.5% vs. 47.4%). Investigators noted the mean time to coloscopy was not significantly different between the intervention group vs. the usual care group (40.5 months vs. 41 months). – by Monica Jaramillo
Reference: Myint A, et al. Abstract 862. Presented at: Digestive Disease Week; May 2-5, 2020; Chicago (meeting canceled).
Disclosures: Myint reports no relevant financial disclosures.