CP6 - Twists, turns, and blockages to Colorectal Screening Follow-up

Poster Type: Research

Category: A. T. Still University

Research Objectives: Cologuard? is a noninvasive alternative to colonoscopy as a colorectal cancer screening tool. However, the test occurs without the supervision of medical personnel, creating several barriers to test completion and result documentation. The purpose of this study is to identify the barriers preventing El Rio Health patients from completing Cologuard?.

Study Design/Methods: The study includes El Rio-El Pueblo patients who had Cologuard? screenings ordered, yet do not have evidence of the results in the Electronic Health Record (EHR). Patients were surveyed via phone call. Investigators followed a script, available in Spanish and English, to determine the potential barriers that prevented a documented Cologuard Screening. If participants did not answer, a second call was attempted within 24 hours, if unsuccessful it was recorded as “no response”. Data were categorized according to the reason that the Cologuard test was not performed or why results were not successfully shared with El Rio.

Principal Findings and Quantitative/Qualitative Results: Fifty-four patients who agreed to complete Cologuard? screening between September to November 2019, but whose EHR show an incomplete test as of March 2020 were contacted via telephone. Of the 54 patients, 33 agreed to the phone survey (n = 33, 61%). A majority understood what Cologuard was 76% (n = 25), received the kit 82% (n = 27), and found the instructions easy to understand 55% (n = 18). A minority needed a replacement kit 18% (n = 6) and forgot to complete the colon screening 12% (n = 4). The survey also revealed a lack of Spanish instructions.

Conclusions on Impact on Health Centers: Survey results show that the most common barriers to adherence of Cologuard? testing are clarity of kit instructions, lack of availability of instructions in Spanish, and problems with kit delivery or replacement. Based on these findings, El Rio Health can create solutions to increase the likelihood of Cologuard? test completion. Our study suggests that variability in patient adherence can be improved if social determinants of health are taken into consideration. We plan to share these findings with El Rio Health and make our survey available to any health center interested in repeating or expanding this study.

Author(s):

Trisha Chaudhury, OMS-II, A. T. Still University

Joshua Bellisario, OMS-II, A. T. Still University

Tushita Verma, OMS-II, A. T. Still University

Kelly Deninger, OMS-II, A. T. Still University

Anna Peterson, OMS-II, A. T. Still University

Kaydee Silva, OMS-II, A. T. Still University

Stephanie Yanez, OMS-II, A. T. Still University

Morgan Chang, OMS-II, A. T. Still University

Jarren Adam, OMS-II, A. T. Still University

Catherine Lin, OMS-II, A. T. Still University

David Lehman, OMS-II, A. T. Still University

Luke Ong, MS, OMS-II, A.T. Still School of Osteopathic Medicine in Arizona

Ray Wagner, MD, MS, FAAP, Regional Director, Medical Education, A T Still University School of Osteopathic Medicine

Christopher Dixon, DO, Regional Director, Medical Education, A T Still University School of Osteopathic Medicine

Kate Whelihan, MPH, CPH, COPC and Public Health Research Specialist, Department of Public Health, A T Still University School of Osteopathic Medicine

Joy H. Lewis, DO, PhD, FACP, Professor, Medicine and Public Health Chair, SOMA Dept. of Public Health, A T Still University School of Osteopathic Medicine