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Multicenter Study
. 2004 Apr;19(4):316-23.
doi: 10.1111/j.1525-1497.2004.30357.x.

Communication factors in the follow-up of abnormal mammograms

Eric G Poon  1 , Jennifer S Haas, Ann Louise Puopolo, Tejal K Gandhi, Elisabeth Burdick, David W Bates, Troyen A Brennan
Affiliations
Multicenter Study

Communication factors in the follow-up of abnormal mammograms

Eric G Poon et al. J Gen Intern Med. 2004 Apr.

Abstract

Objective: To identify the communication factors that are significantly associated with appropriate short-term follow-up of abnormal mammograms.

Design: Prospective longitudinal study involving medical record review and patient survey.

Setting: Ten academically affiliated ambulatory medical practices in the Boston metropolitan area.

Participants: One hundred twenty-six women with abnormal mammograms requiring short-term (6 months) follow-up imaging.

Measurements: Proportion of women in the study who received appropriate follow-up care.

Results: Eighty-one (64%) of the women with abnormal mammograms requiring short-term follow-up imaging received the appropriate follow-up care. After adjusting for patients' age and insurance status, 2 communication factors were found to be independently associated with the delivery of appropriate follow-up care: 1). physicians' documentation of a follow-up plan in the medical record (adjusted odds ratio, 2.79; 95% confidence interval, 1.11 to 6.98; P =.029); and 2). patients' understanding of the need for follow-up (adjusted odds ratio, 3.86; 95% confidence interval, 1.50 to 9.96; P =.006). None of the patients' clinical or psychological characteristics were associated with the delivery of appropriate follow-up care.

Conclusions: Follow-up care for women with abnormal mammograms requiring short-term follow-up imaging is suboptimal. Documentation of the follow-up plan by the physician and understanding of the follow-up plan by the patient are important factors that are correlated with the receipt of appropriate follow-up care for these women. Interventions designed to improve the quality of result follow-up in the outpatient setting should address these issues in patient-doctor communication.

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