De-Implementation Strategy for Mammogram Overuse in Aging Adults

This trial tests a new approach to reduce unnecessary mammograms in women aged 75 and older. Researchers aim to determine if changing how doctors and patients perceive and use mammograms can decrease unneeded screenings. The trial includes two groups: one receives standard care with some improvements, while the other receives a comprehensive multilevel de-implementation strategy to reduce overuse. Women who speak English or Spanish, are 75 or older, and haven't had a mammogram in the last 6 months but did in the 7-18 months prior, might be a good fit.

As an unphased trial, this study offers a unique opportunity to contribute to research that could improve healthcare practices for older women.

The trial information does not specify whether you need to stop taking your current medications. It focuses on reducing mammogram overuse in older women, so it's best to discuss your medications with the trial team or your doctor.

Research shows that the strategy under study aims to reduce unnecessary screening mammograms in women aged 75 and older. This approach changes behaviors and practices at various levels, including patients and healthcare providers, to improve mammogram decision-making.

Researchers are excited about the Multilevel De-Implementation Strategy because it aims to tackle the issue of mammogram overuse in older adults by focusing on reducing unnecessary screenings. Unlike the usual care approach, which often includes routine mammograms without considering individual patient needs, this strategy incorporates both provider and patient education to tailor decisions more closely to each patient's health status. By engaging at multiple levels—organizational, provider, and patient—this approach has the potential to optimize healthcare resources and improve patient outcomes by avoiding unnecessary procedures. This strategy could lead to more personalized care and reduce the risks and costs associated with over-screening.

This trial will compare two approaches to reduce mammogram overuse in aging adults. The Multilevel De-Implementation Strategy, used in one arm of this trial, involves both doctors and patients to help reduce unnecessary mammograms. Studies have shown that excessive mammograms in older women can lead to unnecessary stress and medical treatments. Surveys indicate that many older women feel pressured to have yearly mammograms due to their doctors' recommendations, even when the benefits at their age might be unclear. By addressing these issues, this strategy aims to reduce unwanted mammograms, improving care without risking health. Early studies suggest this approach could effectively balance the pros and cons of screening in older adults. Meanwhile, the other arm of this trial will receive Enhanced Usual Care, which includes organizational-level components of the strategy.¹³⁴⁶⁷