PD15-02 PRACTICE TIME OF PRIMARY CARE PHYSICIANS IS ASSOCIATED WITH CHANGE IN PSA ORDERING HABITS IN THE YEARS SURROUNDING THE UNITED STATES PREVENTATIVE SERVICES TASK FORCE RECOMMENDATION AGAINST PSA SCREENING

INTRODUCTION AND OBJECTIVES: The United States Preventative Services Task Force recommendation against PSA screening came in 2012, a time when many new primary care providers had been trained in the PSA screening era. We examined the differential effect of the recommendation on providers’ PSA screening and ordering habits by date of residency completion. METHODS: We reviewed all resulted PSA orders within a tertiary care academic institution from Jan 2010 to July 2015. Tests were excluded if they were performed by a non-primary care provider (urologist, oncologist or radiation oncologist), if the provider ordered fewer than four tests per year, had a practice break greater than 6 months within the period or if the provider was not employed at the institution for the entire period for any reason. Relative proportions of PSA orders per overall unique male ambulatory clinic volume were assessed for the periods of Jan 1, 2010 to Dec 31, 2011 (first period) and Jan 1, 2013 to July 31, 2015 (second period). Changes on a per-provider basis were assessed as a scatterplot and evaluated with linear regression and ANOVA. RESULTS: Overall unique male non-oncology care patients were 88558 for the first period and 140173 for the second period. 22 primary care providers met criteria. Average period between completion of residency and beginning of period (Jan 1, 2010) was 16 years (range 2-43 years). Average number of unique patients screened per provider in the first period was 138.0 (range 8-696) and 177.5 (range 16-701) in the second period. Providers less than 16 years from residency screened an average of 94.6 and 143.3 men in each period; providers over 16 years from residency screened 253.8 unique men in the first period and 268.7 in the second period (p 1⁄4 0.040 and 0.131 for difference each period). Proportion of all patients screened per overall unique male patient volume did not significantly differ between the two time periods (p 1⁄4 0.122, 95% CI for difference -0.00009 to 0.00067). Change in proportional screening of providers less than 16 years from residency was significantly different from that of providers greater than 16 years from residency (0.00001 vs -0.0009, p 1⁄4 0.023). Proportion of overall unique male patients screened versus time since residency demonstrated a significant negative trend (R2 1⁄4 0.308, p 1⁄4 0.007, slope of trendline -0.000005). CONCLUSIONS: Over the period of 2010 to July 2015 PSA screening per unique male patient did not change significantly for providers in continuous practice throughout the period. Time since residency completion was significantly associated with screening proportionally fewer men over the period. Source of Funding: None