Adherence to screening flexible sigmoidoscopy in asymptomatic patients

Area of Science:

• Preventive Medicine
• Gastroenterology
• Health Services Research

Background:

• Screening flexible sigmoidoscopy is recommended for asymptomatic individuals aged 50 and older.
• Patient adherence to recommended cancer screenings remains a challenge in primary care settings.

Purpose of the Study:

• To assess patient adherence to physician-recommended screening flexible sigmoidoscopy.
• To compare adherence rates among usual care, intervention (educational materials and phone reminder), and physician continuity groups.

Main Methods:

• A study involving 333 asymptomatic patients (age ≥50) in a family practice residency program.
• Data collected via mailed questionnaires from 180 participants to analyze adherence factors.
• Discriminant analysis used to identify predictors of adherence, including demographic, attitudinal, and continuity variables.

Main Results:

• Overall adherence to screening flexible sigmoidoscopy was 30.3%.
• Physician continuity was significantly associated with higher adherence rates (45%; P < 0.001).
• Intervention group showed no significant increase in adherence compared to usual care. Factors like family history, continuity of care, income, perceived pain, and physician communication influenced adherence.

Conclusions:

• Screening flexible sigmoidoscopy is acceptable to asymptomatic patients.
• Longstanding physician continuity positively impacts adherence to screening flexible sigmoidoscopy.
• Addressing patient perceptions of pain and enhancing physician communication are potential strategies to improve adherence.