A 20% decline occurred in the rate of missed appointments for cervical cancer evaluation following a Pap smear when a patient navigator program was initiated at the referral center. The impact of the program and the main reasons for patient no-shows are explored in an article in the Journal of Women’s Health (2015; doi:10.1089/jwh.2014.5111).
Lead author Rebecca Luckett, MD, MPH, and coauthors from Brigham and Women’s Hospital and Dana Farber Cancer Institute, Harvard Medical School, both in Boston, Massachusetts, described how specially trained, culturally sensitive patient navigators guide patients through cancer care. With the appropriate support and assistance, vulnerable patient populations such as African American, Hispanic, and publicly insured women may gain access to improved follow-up care, helping reduce the large racial and socioeconomic disparities in the incidence of and death due to cervical cancer.
The study found that, among 4,199 women evaluated in their clinic between 2006 and 2013, 2,441 (58%) had at least one missed appointment. After the patient navigator program was implemented, no-show rates decline from 49.7% to 29.5%. The researchers found that “45% of patient no-shows were anticipated or a result of a patient misunderstanding and could be mediated with targeted education by the patient navigator.”
“Reducing no-show rates is an important factor in improving health care to vulnerable patient populations, and this study demonstrates the benefit of a patient navigator program in increasing compliance with cervical cancer screening and treatment,” says Susan G. Kornstein, MD, editor-in-chief of Journal of Women’s Health, executive director of the Virginia Commonwealth University Institute for Women’s Health, Richmond, Virginia, and president of the Academy of Women’s Health.
As no-shows were more frequent among African American, Hispanic, and publicly insured patients, the authors suggested that patient navigator programs may reduce disparities in cervical cancer screening and treatment.