Development and evaluation of a consumer information resource, including Patient Decision Aid, for lung cancer screening: a quasi-experimental study
| Autor: | David Manners, Fraser Brims, Simone Pettigrew, Francesco Piccolo, Fiona Lake, Annette McWilliams |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Lung Neoplasms Decision Making Decisional conflict 030204 cardiovascular system & hematology Decision Support Techniques 03 medical and health sciences Behavioral Neuroscience 0302 clinical medicine Interquartile range Consumer information medicine Humans Mass Screening Outpatient clinic 030212 general & internal medicine Lung cancer Early Detection of Cancer Applied Psychology Mass screening Aged Aged 80 and over Smokers business.industry Middle Aged medicine.disease Preference Family medicine Patient Participation business Lung cancer screening |
| Zdroj: | Translational Behavioral Medicine. 10:404-412 |
| ISSN: | 1613-9860 1869-6716 |
| DOI: | 10.1093/tbm/ibz029 |
| Popis: | Lung cancer screening of high-risk individuals with computed tomography is a promising intervention to reduce lung cancer mortality. Patient Decision Aids (PtDAs) may assist eligible individuals assess the risks and benefits associated with screening. Screening preference is high among lower-risk, screening-ineligible individuals and strategies are needed to reduce screening demand among this group. We developed and evaluated a resource comprising a recruitment pamphlet combined with either a PtDA for screening-eligible individuals or an education pamphlet for screening-ineligible individuals. Quasi-experimental pre-post pamphlet exposure design. Ever-smokers aged 55–80 years attending hospital outpatient clinics were invited. Among screening-eligible participants, the assessed outcome was change in score on the Decisional Conflict Scale (DCS). Among screening-ineligible participants, the assessed outcomes were change in screening preference. In the study 51% (55/107) of invited individuals participated, with mean ± standard deviation age 66.9 ± 6.4 years, 53% (29/55) male, and 65% (36/55) eligible for screening. Median (interquartile range) DCS among screening-eligible participants reduced from 28.9 (22.7–45.3) pre-PtDA to 25 (1.6–29.7) post-PtDA (p < .001), but there was no significant change in the proportion that reached the accepted threshold for decisional certainty (DCS < 25, 10/36 [28%] pre-exposure vs. 14/36 [39%] post-exposure, p = .1). Screening preference among screening-ineligible individuals reduced after viewing the screening-ineligible brochure (pre-exposure median of “Prefer” to post-exposure median of “Unsure,” p = .001). Our consumer information pamphlets about lung cancer screening may reduce decisional conflict and improve alignment of screening preference with eligibility. |
| Databáze: | OpenAIRE |
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