Abstract：
Academic detailing, patient-panel management, and mailed, stool-based testing have each been utilized to increase colorectal cancer (CRC) screening in rural clinics. The effectiveness of combining these interventions to increase CRC screening during COVID-19 restrictions was unclear.
We explored the effects of a multi-component intervention including academic detailing, active patient panel management, and mailed MT-sDNA testing on colorectal cancer screening in our rural family medicine clinic. Baseline interventions included EMR-based provider alerts and mailed patient reminders. Our intervention (March-May 2020) and follow-up periods (June-August 2020) coincided with the initial COVID-19 surge, giving us the opportunity to observe the effects of our intervention during COVID-19 restrictions.
A total of 407 patients were eligible and overdue for colorectal cancer screening. Our clinic\'s CRC screening rate increased significantly after intervention (69.7%) as compared with before (64.3%) (P = <0.01; 95%CI = 5.39-5.4). Our clinic\'s CRC screening rates increased significantly during the initial 3 months of the COVID-19 surge (67.8%) compared with the same period the prior year. (62.3%) (P = .003; 95%CI = 3.4-7.6). Our CRC screening rates increased after intervention (69.7%) compared with our regional health system (67%) (P = <0.01; 95%CI = 2.6-2.77). Our weekly stool-based CRC screening increased (94% increase) compared with other health systems nationally (61 to 83% decrease).
A multi-component intervention, including academic detailing, panel management, and mailed MT-sDNA testing, can lead to significant increases in CRC screening in a rural family medicine clinic, empowering providers to maintain an effective CRC screening outreach during COVID-19 related restrictions.
We explored the effects of a multi-component intervention including academic detailing, active patient panel management, and mailed MT-sDNA testing on colorectal cancer screening in our rural family medicine clinic. Baseline interventions included EMR-based provider alerts and mailed patient reminders. Our intervention (March-May 2020) and follow-up periods (June-August 2020) coincided with the initial COVID-19 surge, giving us the opportunity to observe the effects of our intervention during COVID-19 restrictions.
A total of 407 patients were eligible and overdue for colorectal cancer screening. Our clinic\'s CRC screening rate increased significantly after intervention (69.7%) as compared with before (64.3%) (P = <0.01; 95%CI = 5.39-5.4). Our clinic\'s CRC screening rates increased significantly during the initial 3 months of the COVID-19 surge (67.8%) compared with the same period the prior year. (62.3%) (P = .003; 95%CI = 3.4-7.6). Our CRC screening rates increased after intervention (69.7%) compared with our regional health system (67%) (P = <0.01; 95%CI = 2.6-2.77). Our weekly stool-based CRC screening increased (94% increase) compared with other health systems nationally (61 to 83% decrease).
A multi-component intervention, including academic detailing, panel management, and mailed MT-sDNA testing, can lead to significant increases in CRC screening in a rural family medicine clinic, empowering providers to maintain an effective CRC screening outreach during COVID-19 related restrictions.
摘要：
背景：学术细节，患者面板管理，邮寄，以粪便为基础的检测已被用于增加农村诊所的结直肠癌(CRC)筛查.在COVID-19限制期间，结合这些干预措施以增加CRC筛查的有效性尚不清楚。
方法：我们探索了多组分干预的效果，包括学术细节，积极的患者小组管理，并在我们的农村家庭医学诊所邮寄了用于结直肠癌筛查的MT-sDNA检测。基线干预包括基于EMR的提供者警报和邮寄的患者提醒。我们的干预措施（2020年3月至5月）和随访期（2020年6月至8月）与最初的COVID-19激增相吻合，让我们有机会在COVID-19限制期间观察我们的干预效果。
结果：共有407例患者符合结直肠癌筛查条件，且逾期未行。干预后的CRC筛查率（69.7％）与干预前（64.3％）相比显着提高（P=<0.01；95CI=5.39-5.4）。与去年同期相比，在COVID-19激增的最初3个月，我们诊所的CRC筛查率显著增加(67.8%)。（62.3%）（P=0.003；95CI=3.4-7.6）。与我们的区域卫生系统（67％）相比，我们的CRC筛查率在干预后增加了（69.7％）（P=<0.01；95CI=2.6-2.77）。与全国其他卫生系统相比，我们每周以粪便为基础的CRC筛查增加（94％增加）（减少61％至83％）。
结论：多组分干预，包括学术细节，面板管理，邮寄了MT-sDNA测试，可以导致农村家庭医学诊所的CRC筛查显着增加，授权提供者在COVID-19相关限制期间保持有效的CRC筛查外展。
方法：我们探索了多组分干预的效果，包括学术细节，积极的患者小组管理，并在我们的农村家庭医学诊所邮寄了用于结直肠癌筛查的MT-sDNA检测。基线干预包括基于EMR的提供者警报和邮寄的患者提醒。我们的干预措施（2020年3月至5月）和随访期（2020年6月至8月）与最初的COVID-19激增相吻合，让我们有机会在COVID-19限制期间观察我们的干预效果。
结果：共有407例患者符合结直肠癌筛查条件，且逾期未行。干预后的CRC筛查率（69.7％）与干预前（64.3％）相比显着提高（P=<0.01；95CI=5.39-5.4）。与去年同期相比，在COVID-19激增的最初3个月，我们诊所的CRC筛查率显著增加(67.8%)。（62.3%）（P=0.003；95CI=3.4-7.6）。与我们的区域卫生系统（67％）相比，我们的CRC筛查率在干预后增加了（69.7％）（P=<0.01；95CI=2.6-2.77）。与全国其他卫生系统相比，我们每周以粪便为基础的CRC筛查增加（94％增加）（减少61％至83％）。
结论：多组分干预，包括学术细节，面板管理，邮寄了MT-sDNA测试，可以导致农村家庭医学诊所的CRC筛查显着增加，授权提供者在COVID-19相关限制期间保持有效的CRC筛查外展。
