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Review: organisational change and patient involvement may increase the use of prevention cancer screening services

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Data sources
Studies were identified by searching (through February 1999) the Cochrane Effective Practice and Organization of Care Special Register (which includes searches of MEDLINE [from 1966], EMBASE/Excerpta Medica [from 1980], HealthSTAR [from 1975], and the Cochrane Controlled Trials Register [from 1996]), previous systematic reviews, and the Health Care Quality Improvement Projects database.

Study selection
Controlled clinical trials that assessed interventions to increase the use of immunisations for influenza and pneumococcal pneumonia, and use of screening for colon, breast, and cervical cancer in adults were selected for review.

Data extraction
Data were extracted on specific intervention components, study characteristics, and outcomes. Intervention components were classified as reminders to patients or providers, feedback to providers on performance of prevention activities, education of patients or providers, financial incentives to patients or providers, regulatory and legislative actions, organisational change, or mass media campaigns.

Main results
108 studies on immunisations (29 studies), mammography (33 studies), cervical cytology (27 studies), and colon cancer . . . [Full text of this article]

Robert Gluckman, MD

Providence-St Vincent Medical Center
Portland, Oregon, USA