Compliance with mammography guidelines: physician recommendation and patient adherence

Prev Med. 1999 Apr;28(4):386-94. doi: 10.1006/pmed.1998.0443.


Background: Guidelines recommend that women ages 50-75 years receive screening mammography every 1-2 years. We related receipt of physician recommendations for mammography and patient adherence to such recommendations to several 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 ascertained overall compliance with mammography guidelines and two components of compliance: receipt of a physician recommendation and adherence to a recommendation. Outcome measures were the proportion of patients demonstrating each type of compliance and adjusted odds ratios, according to several patient-related characteristics.

Results: Overall, 66% of women received a recommendation. Of women receiving a documented recommendation, 75% adhered. Factors showing significant positive associations with receiving a recommendation included being a patient in the general internal medicine clinic, having private insurance, visiting the clinic more often, and having a recent Pap smear. Patient adherence was positively associated with private insurance and Pap smear history, negatively associated with internal medicine, and not associated with visit frequency.

Conclusions: Patient factors influencing physician mammography recommendations may be different from those associated with patient adherence, except for having private health insurance, which was a predictor of both.

MeSH terms

  • Aged
  • Alabama
  • Breast Neoplasms / prevention & control*
  • Female
  • Guideline Adherence / standards
  • Guideline Adherence / statistics & numerical data*
  • Health Care Surveys
  • Humans
  • Insurance, Health / statistics & numerical data
  • Mammography / economics
  • Mammography / standards*
  • Mammography / statistics & numerical data
  • Middle Aged
  • Patient Compliance / ethnology
  • Patient Compliance / statistics & numerical data*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Primary Health Care / classification
  • Primary Health Care / standards
  • Primary Health Care / statistics & numerical data
  • Referral and Consultation / statistics & numerical data
  • Retrospective Studies
  • Statistics as Topic