DeSalvo Jennifer M, Young Gregory S, Krok-Schoen Jessica L, Paskett Electra D
1 The Ohio State University, Columbus, USA.
J Aging Health. 2018 Sep;30(8):1284-1304. doi: 10.1177/0898264317715184. Epub 2017 Jun 25.
This study aims to test the effectiveness of a patient navigation (PN) intervention to reduce time to diagnostic resolution among older adults age ≥65 years versus those <65 years with abnormal breast, cervical, or colorectal cancer screening exams participating in the Ohio Patient Navigation Research Program (OPNRP).
The OPNRP utilized a nested cohort group-randomized trial design to randomize 862 participants ( n = 67 for ≥65 years; n = 795 for <65 years) to PN or usual care conditions. A shared frailty Cox model tested the effect of PN on time to resolution.
Older adult participants randomized to PN achieved a 6-month resolution rate that was 127% higher than those randomized to usual care ( p = .001). This effect was not significantly different from participants <65 years.
PN significantly reduced time to diagnostic resolution among older adults beginning 6 months after an abnormal cancer screening exam. Health care systems should include this population in PN programs to reduce cancer disparities.
本研究旨在测试患者导航（PN）干预措施在缩短65岁及以上老年人与65岁以下参与俄亥俄州患者导航研究项目（OPNRP）且乳腺癌、宫颈癌或结直肠癌筛查异常的成年人的诊断解决时间方面的有效性。
OPNRP采用嵌套队列组随机试验设计，将862名参与者（65岁及以上67人；65岁以下795人）随机分为PN组或常规护理组。采用共享脆弱性Cox模型测试PN对解决时间的影响。
随机分配到PN组的老年参与者在6个月时的诊断解决率比随机分配到常规护理组的参与者高127%（p = 0.001）。这一效果与65岁以下的参与者没有显著差异。
PN显著缩短了癌症筛查异常6个月后老年患者的诊断解决时间。医疗保健系统应将这一人群纳入PN项目，以减少癌症差异。
