Sa1056 Predictors of Colonoscopy Attendance in a Patient Navigator Program Population

Abstract

noma. The survey was distributed electronically via the American College of Physicians (ACP) Research Center's Internal Medicine Insider Panel, a representative group of ACP members who have voluntarily agreed to participate in periodic physician surveys. Participants were excluded if they reported spending less than 25% of their time in primary care or reported not placing any referrals for screening colonoscopy. Results: Of 442 PCPs invited to participate, 210 responded (response rate = 210/442, or 48%), and 29 were excluded, yielding 181 completed surveys. The mean age was 53 years. 48% practiced in a small group practice, solo practice, or community health center, and only 9% practiced in an academic center. Nearly all (96%) were board certified, and 44% had a medical school affiliation. In a 60-year-old with a normal high-quality screening colonoscopy, 88% (159/ 181) correctly recommended repeat colonoscopy in 10 years. However, if an endoscopist recommended a shorter interval (5 years) in such a patient, 41% (65/159) reported that they would follow the endoscopist's recommendation. For a 55-year-old with a 4 mm adenoma, 73% (133/181) correctly recommended a 5-10 year interval. However, if an endoscopist recommended a shorter interval (3 years) in such a patient, 62% (83/133) reported that they would follow the endoscopist's recommendation. In multivariable analysis, PCPs who referred to larger GI practices, referred more patients for colonoscopy, and worked in non-academic settings, were significantly more likely to follow an early surveillance recommendation. Conclusions: An endoscopist's recommendation for when to repeat a colonoscopy has a powerful impact on the decision-making of referring PCPs. In situations where a guideline-discordant interval is recommended, endoscopists should specify their clinical reasoning and/or indicate the strength of their recommendation.