Effect of inpatient breast cancer education and risk assessment on mammography utilization among hospitalized women post discharge

ABSTRACT

Objective

To evaluate prevalence of nonadherence to breast cancer screening guidelines after bedside educational intervention and informed individualized risk assessment score during an inpatient stay.

Methods

A prospective intervention study was conducted among 507 cancer-free (except skin cancer) women aged 50–75 years hospitalized to a general medicine service. Study intervention included one-on-one bedside education via handout and videos about breast cancer screening and informed individualized risk assessment using the Gail risk model to predict 5-year risk for breast cancer development. Study outcomes were measured using posthospitalization follow-up survey to determine if intervention resulted in improved adherence to breast cancer screening. Chi-square and unpaired t-tests were utilized to compare population characteristics.

Results

The mean age for the study population was 60.5 years (SD = 6.9), the mean 5-year Gail risk score was 1.77 (SD = 1), and 36% of women were African American. One hundred sixty nine (33%) hospitalized women were nonadherent to breast cancer screening recommendations. Only 15% of the nonadherent women were reachable for follow-up survey, and 42% of these women self-reported adherence to screening mammography after a mean follow-up period of 27 months.

Conclusion

This study provides evidence that most women who are nonadherent to breast cancer screening remain nonadherent after hospital discharge despite educational interventions. Our study intervention was only partially successful in enhancing breast cancer screening among hospitalized women who were overdue and at high risk. Further studies need to evaluate strategies to overcome the barriers and improve adherence whenever patients encounter health care system regardless of clinical locale.

KEYWORDS:

• Breast cancer
• nonadherent population
• hospitalized women

Acknowledgments

The authors thank Collaborative Research Interest Group (CRIG), a Johns Hopkins-wide initiative for scholarly collaboration among clinicians across all disciplines, for improving patient-centered care.

Clinical trial registration

Registered with the Cancer Screening Utilization Rates and Cancer Screening Perspectives of Hospitalized Women. Trial registration number: NCT04162925. Date of registration: November 14^th, 2019 ‘Retrospectively registered.’ URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT04162925.

Declaration of funding

No funding was received for the production of this manuscript.

Disclosure of any financial/other conflicts of interest

The authors have no relevant conflicts of interest to disclose. Peer reviewers of this manuscript have no relevant financial or other relationships to disclose.