Americans Lag in Preventive Screenings

Many Americans do not receive recommended preventive screening tests and counseling services during their annual periodic health examinations (PHE). Jennifer Elston Lafata, from Virginia Commonwealth University (Virginia, USA), and colleagues analyzed audio recordings of  484 PHE visits to 64 general internal medicine and family physicians in southeast Michigan conducted from 2007 to 2009, in order to ascertain physician recommendation for or delivery of 19 guideline-recommended preventive services. Alternating logistic regression was used to evaluate factors associated with service delivery. The team found that 46% of eligible and due services were missed during PHEs.  Whereas the services most likely to be delivered were screenings for colorectal cancer, hypertension and breast cancer, patients were least likely to receive counseling about aspirin use and vision screening.  The study authors write that: “A combination of patient, patient-physician relationship, and visit contextual factors are associated with preventive service delivery. Additional studies are warranted to understand the complex interplay of factors that support and compromise preventive service delivery.”