Adapting the PPRNet TRIP QI Model to Increase Colorectal Cancer Screening in Primary Care

Abstract

Background: Established CRCS guidelines for providers and the public exist, but due to several versions of CRCS guidelines and the variety of test options, confusion often arises among patients and providers, adversely affecting CRCS rates. Improving providers’ opportunities to recommend CRCS through provider-directed office-system interventions is critical to increase CRCS rates. Objective: The purpose of this study was to demonstrate the feasibility of adapting provider-directed office-system interventions developed by the Practice Partner Research Network (PPRNet) Translation of Research into Practice (TRIP) Quality Improvement (QI) Model for implementation in an independent, rural West Virginia primary care practice, and to obtain estimates of variability for relevant outcome measures of the interventions to increase CRCS recommendation and rates. Methods: Retrospective and prospective patient data from medical records and electronic medical records were extracted to compare pre-with post-intervention CRCS rates and analyze any significant demographic data. Also, office staff participated in a focus group interview. Results: The pre-intervention CRCS status/completion rate was 4.3% and increased to 36.2%. CRCS recommendation rate rose from 4.3% to 42.1%. Patients in the post group were almost 7 times more likely to get CRCS recommendation compared to patients in the pre group, adjusting for demographic information. Similar to findings for CRCS recommendations, patients in the post group were more than 12 times more likely to have CRCS completion compared to their counterparts in the pre-group (OR 12.61, p < 0.000, CI: 8.30, 19.15). Conclusion: This study demonstrated the feasibility as well as statistically significant preliminary indications that CRCS rates will increase after implementation of this model.