IMPROVING RATE OF LUNG CANCER SCREENING IN PRIMARY CARE CLINIC

Abstract

SESSION TITLE: Lung Cancer Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: The National Lung Cancer Screening Trial showed reduced lung cancer mortality with low-dose computed tomography (LDCT) screening. Although LDCT is generally covered by private and government insurance, the rate of LDCT screening is reported to be about 2-3% in previous studies. One of the main barrier in adequate screening was assessment of smoking history to identify eligible populations. Our study aims to address this barrier and improve the rate of lung cancer screening in Medstar Washington Hospital Center Internal Medicine (WHCIM) clinics. We aim to achieve an improvement from a baseline rate of 2.88% by 50% over a 3-month period. METHODS: Data from cumulative patient visits at WHCIM clinic was collected over a 2 week period to assess the baseline rate of LDCT screening. After multidisciplinary team meeting to assess the barriers in adequate screening, we piloted a clinical reminder in the form of print-out form given to physicians from the medical assistants. This served to remind physicians to take detailed smoking histories and included the current lung cancer screening guidelines. This reminder is being given to providers for each patient seen in the clinic and the results will be followed for the next 3 months. For this study post-intervention data was collected over a 2 week period. RESULTS: Preceding the intervention, providers documented a smoking history in 16% of patients seen where post-intervention was 26%. Prior to the clinical reminder 2.88% of all patients seen over the age of 55 were referred for lung cancer screening which has now increased to 6.0%. Of patients who met the criteria for lung cancer screening, prior to the intervention only 42% of patients were referred for LDCT. However, after the clinical reminder has been initiated, 86% of patients who did meet the criteria were sent for screening. CONCLUSIONS: Our intervention has increased documentation of smoking history by 62% and lung cancer screening, for those who meet the criteria according to the guidelines, by a relative increase of 105%. We are currently working on further interventions to incorporate this clinical reminder into the electronic medical record and to implement this across the Medstar Health Hospitals. CLINICAL IMPLICATIONS: Lung cancer is the leading cause of death not only in the United States, but throughout the world. Improving the rate of lung cancer screening by addressing barriers is a simple and cost-effective method that would go a long way in lowering lung cancer mortality. Furthermore, multidisciplinary team involvement helps address gaps in patient care in a holistic manner. DISCLOSURES: No relevant relationships by Anika Bhargava, source=Web Response No relevant relationships by Akshay Kohli, source=Web Response no disclosure on file for Irina Veytsman