Mollica MA, et al. - Associations between experiences of care and adherence to surveillance guidelines among Medicare Fee-For-Service beneficiaries with colorectal cancer (CRC), were probed. Patient-provider relationships were potentially important in adherence to office visits for CRC surveillance. As adherence appeared to increase survival among CRC survivors, experts proposed future examination to identify specific components of this relationship that impacted office visit adherence, and other potentially modifiable drivers of surveillance guidelines.

Methods

• Local/regional CRC survivors diagnosed in 1999–2009 aged 65+, who underwent surgical resection and completed a CAHPS survey <36 months of diagnosis were ascertained by using linked data from the National Cancer Institute’s Surveillance, Epidemiology, and End results (SEER) cancer registry program and the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience surveys (SEER-CAHPS).
• They defined adherence for a 3-year observation period as receiving a colonoscopy; ≥2 carcinoembryonic antigen (CEA) tests; and each year had ≥2 office visits and ≥1 computerized tomography test.

Results

• In this study, many of the 314 participants reported ratings of a 9 or 10 out of 10 for overall care (55.4%), personal doctor (58.6%), health plan (59.6%), and specialist doctor (47.0%).
• For office visits, adherence to post-resection surveillance was 76.1%, for CEA testing it was 36.9%, for colonoscopy it was 48.1%, and 10.3% for CT Imaging.
• Findings categorized 37.9% of the sample as non-adherent (adhering to ≤1 surveillance guideline).
• Ratings of personal doctor and specialist doctor portrayed a positive association with adherence to office visits, and ratings of personal doctor were associated with adherence overall, in multivariable models.