Sunny Ajeesh, Rustveld Luis
Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA.
J Cancer Educ. 2018 Apr;33(2):251-259. doi: 10.1007/s13187-016-1140-0.
Although the general assumption is that patient navigation helps patients adhere to CRC screening recommendations, concrete evidence for its effectiveness is still currently under investigation. The present literature review was conducted to explore effectiveness of patient navigation and education on colorectal cancer (CRC) screening completion in medically underserved populations. Data collection included PubMed, Google Scholar, and Cochrane reviews searches. Study inclusion criteria included randomized controlled trials and prospective investigations that included an intervention and control group. Case series, brief communications, commentaries, case reports, and uncontrolled studies were excluded. Twenty-seven of the 36 studies screened for relevance were selected for inclusion. Most studies explored the utility of lay and clinic-based patient navigation. Others implemented interventions that included tailored messaging, and culturally and linguistically appropriate outreach and education efforts to meet CRC screening needs of medically underserved individuals. More recent studies have begun to conduct cost-effectiveness analyses of patient navigation programs that impacted CRC screening and completion. Peer-reviewed publications consistently indicate a positive impact of patient navigation programs on CRC screening completion, as well have provided preliminary evidence for their cost-effectiveness.
尽管一般认为患者导航有助于患者遵循结直肠癌筛查建议,但目前其有效性的具体证据仍在研究中。进行本次文献综述是为了探讨患者导航和教育对医疗服务不足人群完成结直肠癌(CRC)筛查的有效性。数据收集包括在PubMed、谷歌学术和考科蓝综述中进行检索。研究纳入标准包括随机对照试验和前瞻性调查,其中要有干预组和对照组。排除了病例系列、简短通讯、评论、病例报告和非对照研究。筛选出的36项相关研究中有27项被选入。大多数研究探讨了外行人及基于诊所的患者导航的效用。其他研究实施的干预措施包括定制信息传递,以及开展文化和语言适宜的外展及教育工作,以满足医疗服务不足人群的结直肠癌筛查需求。最近的研究已开始对影响结直肠癌筛查和完成情况的患者导航项目进行成本效益分析。同行评审的出版物一致表明患者导航项目对完成结直肠癌筛查有积极影响,同时也为其成本效益提供了初步证据。