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Prev Med. 2007 Jan;44(1):26-33. Epub 2006 Sep 8.

Patient navigation and case management following an abnormal mammogram: a randomized clinical trial.

Author information

1
University of Southern California, School of Social Work, USA. ell@usc.edu

Abstract

BACKGROUND:

A high rate of low-income, ethnic minority women delay or fail to keep appointments following abnormal mammograms. This study was designed to test the effectiveness of a structured counseling and patient navigation intervention for improving follow-up rates at a large public sector medical center.

METHODS:

This randomized clinical trial, conducted in Los Angeles 2001-2002, included 204 women with abnormal mammograms referred for follow-up who were then assigned to intervention or usual care. The primary outcome was the rate of follow-up through diagnostic resolution within eight months.

RESULTS:

The intervention resulted in a significant increase in the rate of adherence to follow-up through diagnostic resolution. The intervention group was much more likely to be adherent through diagnostic resolution than the control group (90% vs. 66%, OR=4.48, p<0.001) and were more likely to experience timely adherence than UC patients (77% vs. 57%, OR=2.5, p=0.01). Intervention effectiveness was not significantly different for women assigned to different levels of service intensity.

CONCLUSIONS:

Patient navigation and counseling driven by a structured clinical algorithm are highly effective strategies to improve diagnostic resolution follow-up among low-income, ethnic minority women with abnormal mammograms. The intervention algorithm and available training materials can be adapted for diverse care systems serving high-risk women to decrease loss to follow-up.

PMID:
16962652
DOI:
10.1016/j.ypmed.2006.08.001
[Indexed for MEDLINE]

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