P2161 - Utilization of Patient Counseling to Increase Colorectal Cancer Screening Rates in an Internal Medicine Resident Continuity Clinic

Vedika Rajasekaran, MD, Jennifer Headrick, MD
Wellstar Kennestone, Marietta, GA

Introduction: Colorectal Cancer (CC) screening is important for the early detection of CC. Current Screening tools available are: FIT test, FIT- DNA (Cologuard), Septin 9, Colon Capsule, CT colonography, and colonoscopy. The purpose of our project was to implement a colon cancer screening counseling Epic Smart phrase in our resident run Internal Medicine continuity clinic. We then compared adherence to Fit test, colonoscopy, and Cologuard screening methods for patients who were counseled using the Epic Smart phrase (Epic SP) and those who were not counseled using the Epic SP.

Methods: Between August 1^st, 2023, and January 31^st, 2024, all Internal Medicine residents in our office were encouraged to utilize a premade Epic SP to counsel average-risk patients who were due for colorectal cancer screening. This smart phrase provided clear language to help them to discuss three different screening modalities that were available to patients in the clinic. We encouraged this using daily reminders at morning huddle, and written reminders posted in the clinic. During the study period, 281 patients had orders placed for colorectal cancer screening and had some type of discussion about colorectal cancer. Of these 281 patients, 45 patients were counseled with the Epic SP and 236 were counseled using usual care. Descriptive statistics were done using chi-squared and Fisher’s Exact Test.

Results: Of the 45 patients who were counseled with the Epic SP, 31.1% of patients completed the recommended screening, but 68.8% did not complete the screening. Of the patient encounters where the Epic Smart phrase was not utilized, only 2.1% of patients completed the recommended screening test (p< 0.001). Of the patients who were counseled using the Epic Smart phrase, colonoscopy was the most common modality ordered, but Cologuard test had the highest rate of follow-up (70%).

Discussion: Our results show both a clinical and statistical significance in colon cancer screening follow-up with the use of the Epic Smart phrase. It is important to note that our study included a relatively small sample size, so we are unable to determine if another factor like race or insurance type affected these adherence results. Future direction for this study would be to encourage more consistent use of the Epic Smart phrase to guide discussions about colorectal cancer screening counsel. We would also like to repeat this study with a larger patient population to search for other barriers to completion of screening such as social determinants of health.


Disclosures:


Vedika Rajasekaran, MD, Jennifer Headrick, MD. P2161 - Utilization of Patient Counseling to Increase Colorectal Cancer Screening Rates in an Internal Medicine Resident Continuity Clinic, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.