Prostate Specific Antigen Ordering After Implementation of a Point-of-Care Reminder to Discuss Screening

Area of Science:

• Urology
• Preventive Medicine
• Health Informatics

Background:

• Prostate-specific antigen (PSA) screening for prostate cancer has a "C" recommendation for men aged 55-69.
• A health system implemented an electronic reminder in January 2023 to prompt clinicians about PSA screening discussions for men aged 55-69.

Purpose of the Study:

• To evaluate the impact of an electronic medical record (EMR) reminder on PSA ordering rates.
• To assess PSA ordering trends in targeted and non-targeted age groups post-implementation.

Main Methods:

• Interrupted time series analyses were used to assess monthly PSA ordering rates.
• Data were collected from January 2022 to July 2024.
• Analysis included men aged 55-69 (targeted) and 50-54, 70-74, and ≥75 years (non-targeted).

Main Results:

• PSA orders increased significantly in the targeted group (median 6.4% to 10.2% of visits, aIRR 1.57).
• PSA ordering also increased in non-targeted groups: 50-54 years (aIRR 1.44), 70-74 years (aIRR 1.26), and ≥75 years (aIRR 1.11).

Conclusions:

• EMR reminders effectively increased PSA ordering in the intended age group.
• The reminder also led to increased PSA orders in older age groups, where screening benefits may be less favorable.
• Further evaluation is needed regarding the risk-benefit balance of increased PSA screening in all age groups.