ASPO Abstracts
A Patient Navigation Tracking Log: Results for Diagnostic Colonoscopy Completion after Abnormal Fecal Immunochemical Test (FIT)
Category: Cancer Health Disparities
Conference Year: 2019
Abstract Body:
Title: A Patient Navigation Tracking Log: Results for Diagnostic Colonoscopy Completionafter Abnormal Fecal Immunochemical Test (FIT)Purpose Individuals with an abnormal fecal immunochemical test (FIT) as part of colorectalcancer (CRC) screening who do not complete colonoscopy have a 2.5-fold increased risk forcancer death. Barriers to colonoscopy uptake after an abnormal FIT vary among differentsocial and racial/ethnic communities. Our goal is to report the actions and outcome of thebarriers faced largely by Hispanic/Latino patients in a federally qualified health center(FQHC) in San Diego California. Methods Patients were referred to a FQHC bilingual patient navigator (PN) in San Diego’spredominantly Latino communities. Patient navigation was primarily completed via telephoneincluding education, emotional support, and scheduling. The goal of CRC screeningnavigation is completion of diagnostic colonoscopy following an abnormal FIT. Thenavigation barriers and PN actions were tracked and documented using a PN log. Results During the period of March 2017 to June 2018, 123 patients at the participatingclinic had an abnormal FIT. The participants were on average 60 years old Latinos (88%),mostly female (60%), preferred Spanish as primary language (76%) and were Medicaid insured(82%). Four were not eligible for navigation, as they had already completed thecolonoscopy, leaving 119 navigation eligible patients. Of the 119, all were contacted atleast once; 71 were navigated by the PN. Among the persons who received assistance (i.e.,all those who were navigated) the most common barriers were lack of social and practicalsupport (16%), financial difficulties (12%) and inadequate insurance (12%). Among the 71navigated patients, the rate of colonoscopy completion was 41%. Eleven percent declinedservices because they were not concerned with the abnormal FIT, and 20% declined servicesdue to lack of funding for a diagnostic colonoscopy. The loss to follow up rate was 27%.Conclusions - Completion of diagnostic colonoscopy following navigation (41%) is low and can be improved.- The lack of support is a barrier a PN can address; inadequate health insurance is asignificant challenge. - The primary reason for diagnostic colonoscopy no
Keywords: abnormal FITColorectal cancerHispanicsFederally qualifiedhealth center