Factors influencing lung cancer screening completion following participation in shared decision-making: A retrospective study in a U.S. academic health system.

Autor: Rennert L; Department of Public Health Sciences, Clemson University, Clemson, SC, United States. Electronic address: liorr@clemson.edu., Zhang L; Department of Public Health Sciences, Clemson University, Clemson, SC, United States., Lumsden B; Department of Public Health Sciences, Clemson University, Clemson, SC, United States; School of Mathematical and Statistical Sciences, Clemson University, Clemson, SC, United States., Harwood K; School of Osteopathic Medicine, Campbell University, Lillington, NC, United States., Tyler L; School of Medicine, University of South Carolina, Greenville, SC, United States., Ashby M; Department of Public Health Sciences, Clemson University, Clemson, SC, United States., Hanna JW; Department of Radiology, Prisma Health System, Greenville, SC, United States., Gimbel RW; Department of Public Health Sciences, Clemson University, Clemson, SC, United States.
Jazyk: angličtina
Zdroj: Cancer treatment and research communications [Cancer Treat Res Commun] 2020; Vol. 24, pp. 100198. Date of Electronic Publication: 2020 Jul 17.
DOI: 10.1016/j.ctarc.2020.100198
Abstrakt: Purpose: Shared decision making (SDM) between patients and designated health professionals is recommended by several professional organizations prior to lung cancer screening by low dose CT (LDCT). This study seeks to identify factors, including characteristics of patients and referring clinicians, that influence LDCT screening completion following participation in SDM.
Materials and Methods: This retrospective study consisted of n = 171 patients eligible for LDCT screening and who participated in SDM between 2016 and 2017 in one of two sites in Prisma Health, an academic health care delivery system in South Carolina. Patient characteristics included age, sex, race, body mass index, marital status, insurance, smoking status and history, family history of lung cancer, SDM site, and distance to screening site. Characteristics of referred clinicians included age, sex, race, specialty, years of practice, education, and residency. Descriptive statistics and multivariable generalized linear mixed models were used to compare effects of patient and referring clinician characteristics on LDCT completion.
Results: A total of 152 patients (89%) completed LDCT screening after participation in SDM. SDM site (p = 0.02), longer distances to the screening site (p = 0.03), referrals from internal medicine clinicians (p = 0.03), and referrals from younger clinicians (p = 0.01) and from those with less years of experience (p = 0.02) were significantly associated with a lower likelihood of screening completion.
Conclusions: Several factors significantly associated with screening completion were identified. This information can assist with development of interventions to improve communication and decision-making between patients, clinicians, and SDM health professionals, and inform design of targeted decision aids embedded into SDM procedures.
Competing Interests: Declaration of Competing Interest The authors report no conflicts of interest. Dr. Gimbel reports a grant from the Health Sciences Center, Prisma Health System, Greenville, SC that provided stipend support for K. Harwood and L. Tyler as student Research Assistants for the study. Dr. Rennert receives intramural Clemson University support to fund graduate student stipend support for B. Lumsden who contributed to the statistical analyses. The study sponsor had no role in study design; collection, analysis, and interpretation of data; writing the report; and the decision to submit the report for publication.
(Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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