New method increases preventive health screenings for older patients

(SACRAMENTO)

A UC Davis Health study found that an electronic population tool helped ensure patients over 50 got more of the preventive health screenings they needed. The study was published in the American Journal of Medicine. Using the new tool, the research team expanded uptake of preventive health services, especially cancer screenings and vaccinations.

According to the U.S. Census Bureau, individuals 45 and older will make up 43% of the population by 2030. Individuals in this demographic are at a particularly high risk for cancer and vaccine preventable illness. Therefore, the U.S. Preventive Services Task Force and Centers for Disease Control and Prevention have published screening guidelines to maximize their well-being.

“Unfortunately, primary care physicians are inundated with numerous patient health concerns throughout the day and some screening tests can be forgotten,” said Eric Chak, associate  professor of gastroenterology and hepatology and lead investigator on the study. “In California there is currently just a lung cancer screening rate of 1% of eligible adults.”

Electronic population health module

The study is called “Enhancing Electronic Health Systems to Decrease the Burden of Colon Cancer, Lung Cancer, Obesity, Vaccine-Preventable Illness and LivER Cancer,” or CLOVER.

Prior to a patient’s visit, data in the electronic health record was used to bundle orders for colon cancer screening, lung cancer screening, tobacco and obesity counseling, age-appropriate vaccines and hepatitis C screening, if needed.

A pre-visit planner, a nurse who specializes in prevention education, contacted patients before their doctor’s visit. They discussed the interventions and why they are important, and answered questions. The pre-visit planner then ordered tests and vaccines, so they were ready for the physician to finalize with the patient at the appointment.

The data shows CLOVER is an efficient and effective way to increase preventive health services for older patients.” Eric Chak

Study shows increase in preventive care for older adults

During the study, data was collected from a control (non-interventional) clinic within the UC Davis Health system and from a CLOVER intervention clinic. The age and gender of patients was similar in each clinic.  Researchers computed the data-based adherence to health screenings from eligible patients in July 2020 (baseline) and the proportion adherent as of June 2021 at both clinics.

Compared to the control clinic, the intervention clinic had significantly larger increases in adherence to lung cancer screening (212% vs. 40%), obesity counseling (126% vs. 6%), and colon cancer screening (4% vs. 1%), but significantly smaller increases in tobacco counseling (1% vs. 7%) and pneumonia vaccination (5% vs. 8%).

“The data shows CLOVER is an efficient and effective way to increase preventive health services for older patients,” said Chak. “The COVID-19 pandemic has created a shift in how we practice medicine and patients now don't always have the need to see their doctor face-to-face. Being proactive and seeking out those people that are at risk opposed to waiting for them to come to the doctor is an effective way to prevent potential illnesses.”

Expansion of the CLOVER model

Based on the success of the uptake of preventive health services for patients using the CLOVER model, researchers hope to expand the study and replicate the model to additional clinics.

“With the CLOVER model, we are aspiring to streamline healthcare for patients and in some ways create a one-stop shop,” explained Moon S. Chen Jr., professor in population sciences and health disparities and one of the principal investigators on the study. “With the aging population in the United States, we have a tremendous opportunity to connect with older patients and actively work towards preventing future illnesses.”

The study is funded by a two-year, $600,000 grant from the National Institutes of Health. it’s the first stage of the program will wrap up in July 2022. Researchers hope to expand the study through additional clinics at UC Davis and UC Irvine through another three-year, $2.1 million grant.

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