Compliance with mammography guidelines: Physician recommendation and patient adherence

Background Guidelines recommend that women ages 50-75 years receive screeni ng mammography every 1-2 years. We related receipt of physician recommendat ions for mammography and patient adherence to such recommendations to sever al patient characteristics. Methods. We retrospectively reviewed medical records of 1,111 women ages 50 -75 attending three clinics in an urban university medical center. We ascer tained overall compliance with mammography guidelines and two components of compliance: receipt of a physician recommendation and adherence to a recom mendation. Outcome measures were the proportion of patients demonstrating e ach type of compliance and adjusted odds ratios, according to several patie nt-related characteristics. Results. Overall, 66% of women received a recommendation. Of women receivin g a documented recommendation, 75% adhered. Factors showing significant pos itive associations with receiving a recommendation included being a patient in the general internal medicine clinic, having private insurance, visitin g the clinic more often, and having a recent Pap smear. Patient adherence w as positively associated with private insurance and Pap smear history, nega tively associated with internal medicine, and not associated with visit fre quency. Conclusions, Patient factors influencing physician mammography recommendati ons may be different from those associated with patient adherence, except f or having private health insurance, which was a predictor of both. (C) 1999 American Health Foundation and Academic Press.