Effects of physician prompters on long-term screening test behaviors.

Background: This study examines the long term effects of a prompter directed at a single screening test on the performance of preventive tests 12 to 24 months later.

Methods: A retrospective chart review was performed that compared 114 patients who had a Papanicolau (Pap) smear prompter placed on their charts in 1990 with 86 patients who did not have a prompter placed. Chart audits determined if a Pap smear, breast examination, mammogram, rectal examination, stool occult blood, or serum cholesterol determination was performed 12 to 24 months after the prompter had been placed.

Results: In the patient population that received prompters more than one year earlier, a significant increase was observed in Pap smears (40% vs 24%, p = 0.05), breast examinations (37% vs 20%, p = 0.009), and digital rectal examinations in patients 50 years of age and older (20% vs 0%).

Conclusions: When a prompter is placed on a chart to change physician behavior, a lasting effect is seen over one year later. However, increased screening is only observed in patients who initially had prompters placed on their charts. This may indicate that this change in screening behaviors is due to alterations in patient and not physician behaviors.