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Improving Mammography Screening Using Best Practices and Practice Enhancement Assistants: An Oklahoma Physicians Resource/Research Network (OKPRN) Study

Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center (CBA, JWM)
Oklahoma Foundation for Medical Quality (ME, LH), Oklahoma City

Correspondence: Corresponding author: Cheryl B. Aspy, PhD, Family and Preventive Medicine, University of Oklahoma Health Sciences Center, 900 NE 10th Street, Oklahoma City, OK 73104 (E-mail: cheryl-aspy{at}ouhsc.edu)

Purpose: In 2004 only 68% of women in Oklahoma over the age of 40 reported having a mammogram in the past 2 years, compared with 75% nationally. Strategies to improve mammography rates have been numerous but have generally included single strategies, such as physician education, practice audit and feedback, and reminders; flow sheets and results have been mixed. The purpose of this randomized controlled trial was to determine the impact of a practice facilitator and "best practice" interventions on mammography rates in a practice-based research network.

Methods: A total of 16 practices participated; 8 were assigned to intervention and 8 to usual care. Pre- and post-audits of mammography rates were conducted. Intervention practices received feedback with benchmarking, academic detailing, and the assistance of a practice enhancement assistant to help with practice redesign over a 9-month period.

Results: The groups differed significantly for both the proportion of mammograms offered to eligible patients (P = .043) and for the proportion of patients with current mammograms (P < .015). For the control group, 38% of eligible women were offered a mammogram and 202 (35% of those eligible) actually did have documentation that a mammogram had been performed. Fifty-three percent of the eligible patients in the intervention group were offered a mammogram and 52% of those eligible (n = 332) did have documentation in the chart that the mammogram had been completed.

Conclusion: The results suggest that these interventions can improve mammography rates in a range of practice settings. These findings are consistent with other studies that have tested multicomponent interventions.

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				M. A. Bowman, A. V. Neale, and P. Lupo Third Journal of the American Board of Family Medicine Practice-based Research Theme Issue J Am Board Fam Med, July 1, 2008; 21(4): 255 - 257. [Full Text] [PDF]

				J. W. Mold, C. A. Aspy, and Z. Nagykaldi Implementation of Evidence-Based Preventive Services Delivery Processes in Primary Care: An Oklahoma Physicians Resource/Research Network (OKPRN) Study J Am Board Fam Med, July 1, 2008; 21(4): 334 - 344. [Abstract] [Full Text] [PDF]