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初级保健医生与其患者的结直肠癌筛查状况之间的关联:来自瑞士Sentinella基于实践的研究网络的证据。

Association between the colorectal cancer screening status of primary care physicians and their patients: Evidence from the Swiss Sentinella practice-based research network.

作者信息

Scharf Tamara, Hügli Claudia, Martin Yonas, Tal Kali, Biller-Andorno Nikola, Dvořák Charles, Bulliard Jean-Luc, Ducros Cyril, Selby Kevin, Auer Reto

机构信息

Institute of Primary Health Care (BIHAM), University of Bern, Switzerland.

Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

出版信息

Prev Med Rep. 2023 Feb 13;32:102140. doi: 10.1016/j.pmedr.2023.102140. eCollection 2023 Apr.

Abstract

Swiss health insurance reimburses screening for colorectal cancer (CRC) with either colonoscopy or fecal occult blood test (FOBT). Studies have documented the association between a physician's personal preventive health practices and the practices they recommend to their patients. We explored the association between CRC testing status of primary care physicians (PCP) and the testing rate among their patients. From May 2017 to September 2017, we invited 129 PCP who belonged to the Swiss Sentinella Network to disclose their CRC test status and whether they had been tested with colonoscopy or FOBT/other methods. Each participating PCP collected demographic data and CRC testing status from 40 consecutive 50- to 75-year-old patients. We analyzed data from 69 (54%) PCP 50 years or older and 2623 patients. Most PCP were men (81%); 75% were tested for CRC (67% with colonoscopy and 9% with FOBT). Mean patient age was 63; 50% were women; 43% had been tested for CRC (38%, 1000/2623 with colonoscopy and 5%, 131/2623, with FOBT or other non-endoscopic test). In multivariate adjusted regression models that clustered patients by PCP, the proportion of patients tested for CRC was higher among PCP tested for CRC than among PCP not tested (47% vs 32%; OR 1.97; 95% CI 1.36 to 2.85). Since PCP CRC testing status is associated with their patients CRC testing rates, it informs future interventions that will alert PCPs to the influence of their health decisions and motivate them to further incorporate the values and preferences of their patients in their practice.

摘要

瑞士医疗保险为结肠镜检查或粪便潜血试验(FOBT)筛查结直肠癌(CRC)提供报销。研究记录了医生个人的预防性健康行为与其向患者推荐的行为之间的关联。我们探讨了初级保健医生(PCP)的CRC检测状况与其患者检测率之间的关联。在2017年5月至2017年9月期间,我们邀请了129名属于瑞士哨兵网络的初级保健医生披露他们的CRC检测状况,以及他们是否接受过结肠镜检查或FOBT/其他方法的检测。每位参与的初级保健医生收集了40名连续的50至75岁患者的人口统计学数据和CRC检测状况。我们分析了69名(54%)50岁及以上的初级保健医生和2623名患者的数据。大多数初级保健医生为男性(81%);75%接受了CRC检测(67%通过结肠镜检查,9%通过FOBT)。患者的平均年龄为63岁;50%为女性;43%接受了CRC检测(38%,1000/2623通过结肠镜检查,5%,131/2623通过FOBT或其他非内镜检查)。在按初级保健医生对患者进行聚类的多变量调整回归模型中,接受CRC检测的初级保健医生的患者中接受CRC检测的比例高于未接受检测的初级保健医生(47%对32%;OR 1.97;95%CI 1.36至2.85)。由于初级保健医生的CRC检测状况与其患者的CRC检测率相关,这为未来的干预措施提供了信息,这些干预措施将提醒初级保健医生注意其健康决策的影响,并促使他们在实践中进一步纳入患者的价值观和偏好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e19f/9971517/b14142de75e6/gr1.jpg

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