Abstract
BackgroundCancer screening‐related decisions require patients to evaluate complex medical information in short time frames, often with primary care providers (PCPs) they do not know. PCPs play an essential role in facilitating comprehensive shared decision making (SDM).ObjectiveTo develop and test a decision aid (DA) and SDM strategy for PCPs and high‐risk patients.DesignThe DA was tested with 20 dyads. Each dyad consisted of one PCP and one patient eligible for screening. A prospective, one‐group, mixed‐method study design measured fidelity, patient values, screening intention, acceptability and satisfaction.ResultsFour PCPs and 20 patients were recruited from an urban academic medical centre. Most patients were female (n = 14, 70%), most had completed high school (n = 15, 75%), and their average age was 65 years old. Half were African American. Patients and PCPs rated the DA as helpful, easy to read and use and acceptable in terms of time frame (observed t = 11.6 minutes, SD 2.7). Most patients (n = 16, 80%) indicated their intent to be screened. PCPs recommended screening for most patients (n = 17, 85%).ConclusionsEvidence supports the value of lung cancer screening with LDCT for select high‐risk patients. Guidelines endorse engaging patients and their PCPs in SDM discussions. Our findings suggest that using a brief, interactive, plain‐language, culturally sensitive, theory‐based DA and SDM strategy is feasible, acceptable and may be essential to effectively translate and sustain the adoption of LDCT screening recommendations into the clinic setting.
Highlights
Cancer screening-related decisions can require patients to evaluate complex medical information in short time frames, often with primary care providers (PCPs) they do not know
Using a model development process, components of the decision- balance portion of the decision aid (DA) were developed by the primary author, and consensus was reached with the help of an interdisciplinary research team, three nationally known content experts in decision making and lung cancer screening, plus three laypersons.[29]
The DA incorporated IPDASi standards, including all 7 of 7 defining criteria, 8 of 9 criteria to reduce bias, 2 of 4 criteria related to screening and 10 of 13 quality criteria
Summary
Cancer screening-related decisions can require patients to evaluate complex medical information in short time frames, often with primary care providers (PCPs) they do not know. SDM is a collaborative communication strategy that allows patients and their PCPs to make health-care decisions together, taking into account the best clinical evidence available as well as the patient’s values and preferences. Cancer screening-related decisions require patients to evaluate complex medical information in short time frames, often with primary care providers (PCPs) they do not know. Conclusions: Evidence supports the value of lung cancer screening with LDCT for select high-risk patients. Our findings suggest that using a brief, interactive, plain-language, culturally sensitive, theory-based DA and SDM strategy is feasible, acceptable and may be essential to effectively translate and sustain the adoption of LDCT screening recommendations into the clinic setting
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