Background: To evaluate prevalence of non-adherence 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 video about breast cancer screening and informed individualized risk assessment using GAIL risk model to predict 5-year-risk for breast cancer development. A follow up survey was conducted after hospital discharge to determine if intervention resulted in improving adherence to breast cancer screening. Chi-square and unpaired t-tests were utilized to compare population characteristics.
Results: Mean age for the study population was 60.5 years (SD=6.9), mean 5-year Gail risk score was 1.77 (SD=1), and 36% of women were African American. 169 (33%) hospitalized women were non-adherent to breast cancer screening recommendations. Only 15% of the non-adherent 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.
Conclusions: The study provides evidence that most women who are non-adherent to breast cancer screening remain non-adherent 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 patient encounter health care system regardless of clinical locale.