Enhancing compliance with screening mammography recommendations: a clinical trial in a primary care office

Abstract

Background and objectives: Despite consensus that screening mammography is an appropriate preventive tool, many women do not receive this examination. This study was undertaken to evaluate the relative efficacy and cost-effectiveness of three interventions designed to increase mammography rates.

Methods: A total of 151 women, aged 50-59, were randomized into four groups: control, physician telephone call, medical assistant telephone call, and physician letter.

Results: The women in the medical assistant telephone call group (16 of 37 = 43%) and the physician telephone call group (11 of 38 = 29%) responded significantly better than those in the control group (4 of 38 = 11%) (P < .05). None of the 10 widows in the entire study obtained a mammogram, compared with 38 of 141 (27%) women in all other marital groups (P < .05). The cost per intervention and cost per mammogram obtained were, respectively, physician telephone call: $15, $51.82; physician letter: $2.50, $13.57; medical assistant call: $1.30, $3.

Conclusions: Medical assistant telephone callers are a cost-effective strategy to encourage mammography adherence. Widows appear particularly resistant to all screening mammography interventions.