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Barriers of and facilitators to physician recommendation of colorectal cancer screening.
- Source :
-
Journal of general internal medicine [J Gen Intern Med] 2007 Dec; Vol. 22 (12), pp. 1681-8. Date of Electronic Publication: 2007 Oct 16. - Publication Year :
- 2007
-
Abstract
- Background: Colorectal cancer screening (CRCS) has been demonstrated to be effective and is consistently recommended by clinical practice guidelines. However, only slightly over half of all Americans have ever been screened. Patients cite physician recommendation as the most important motivator of screening. This study explored the barriers of and facilitators to physician recommendation of CRCS.<br />Methods: A 3-component qualitative study to explore the barriers of and facilitators to physician recommendation of CRCS: in-depth, semistructured interviews with 29 purposively sampled, community- and academic-based primary care physicians; chart-stimulated recall, a technique that utilizes patient charts to probe physician recall and provide context about the barriers of and facilitators to physician recommendation of CRCS during actual clinic encounters; and focus groups with 18 academic primary care physicians. Grounded theory techniques of analysis were used.<br />Results: All the participating physicians were aware of and recommended CRCS. The overwhelmingly preferred test was colonoscopy. Barriers of physician recommendation of CRCS included patient comorbidities, prior patient refusal of screening, physician forgetfulness, acute care visits, lack of time, and lack of reminder systems and test tracking systems. Facilitators to physician recommendation of CRCS included patient request, patient age 50-59, physician positive attitudes about CRCS, physician prioritization of screening, visits devoted to preventive health, reminders, and incentives.<br />Conclusion: There are multiple physician, patient, and system barriers to recommending CRCS. Thus, interventions may need to target barriers at multiple levels to successfully increase physician recommendation of CRCS.
- Subjects :
- Adult
Aged
Colonoscopy statistics & numerical data
Female
Guideline Adherence
Humans
Male
Mass Screening methods
Middle Aged
Occult Blood
Patient Participation
Sigmoidoscopy statistics & numerical data
Attitude of Health Personnel
Colorectal Neoplasms diagnosis
Colorectal Neoplasms prevention & control
Communication Barriers
Health Services Accessibility
Mass Screening statistics & numerical data
Physician-Patient Relations
Practice Patterns, Physicians' statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1525-1497
- Volume :
- 22
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Journal of general internal medicine
- Publication Type :
- Academic Journal
- Accession number :
- 17939007
- Full Text :
- https://doi.org/10.1007/s11606-007-0396-9