While many patients find at-home colorectal cancer screening tests (known as fecal immunochemical tests or FIT) more comfortable than those performed in the clinic, FIT collection is dependent upon the patient closely following provided instructions. This can be more difficult if the user has undiagnosed cognitive impairments. In a new study, researchers distributed a simple cognitive test alongside at-home FITs to 1,448 patients to determine if mild, undiagnosed cognitive impairment might be leading to an increase of invalid samples.
Eleven percent of completed FIT stool specimens were incorrectly collected, with approximately 25% of the erroneous samples submitted by individuals who screened positive for cognitive impairment. The most common collection errors included having too much stool in the vial; stool on the wrong end of the vial; and stool on the wrong side of the slide. Additionally, the researchers found that patients with an eighth-grade education level or less were also more likely to make errors in the collection process. The findings suggest that health care staff should consider the education level and cognitive function of patients before asking them to perform an at-home FIT test.
Clock Drawing Test: Use as a Screening Tool for Cognitive Impairment Associated With Fecal Immunochemical Test Collection Errors
Jeanette M Daly, RN, PhD, et al
Department of Family Medicine, University of Iowa, Iowa City
Pre-embargo article link
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Annals of Family Medicine is a peer-reviewed, indexed research journal that provides a cross-disciplinary forum for new, evidence-based information affecting the primary care disciplines. Launched in May 2003, Annals is sponsored by seven family medical organizations, including the American Academy of Family Physicians, the American Board of Family Medicine, the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, the North American Primary Care Research Group, and The College of Family Physicians of Canada. Annals is published six times each year and contains original research from the clinical, biomedical, social and health services areas, as well as contributions on methodology and theory, selected reviews, essays and editorials. Complete editorial content and interactive discussion groups for each published article can be accessed free of charge on the journal’s website, www.AnnFamMed.org.