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LungCARE: Encouraging Shared Decision-Making in Lung Cancer Screening-a Randomized Trial.

Judith M E Walsh1,2,3, Leah Karliner4,5, Ashley Smith4

  • 1Department of Medicine, Division of General Internal Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA. judith.walsh@ucsf.edu.

Journal of General Internal Medicine
|August 31, 2023
PubMed
Summary

The LungCARE tool improved lung cancer screening (LCS) discussions, referrals, and completion rates among high-risk patients in primary care. This novel approach enhanced patient knowledge and engagement in LCS decisions.

Keywords:
lung cancer screeningshared decision-making

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Area of Science:

  • Primary Care Medicine
  • Public Health
  • Oncology

Background:

  • Lung cancer screening (LCS) is recommended for high-risk individuals, emphasizing shared decision-making (SDM).
  • Effective SDM strategies in busy primary care settings for LCS remain underexplored.

Approach:

  • A pilot cluster randomized controlled trial was conducted to evaluate the Lung Cancer Assessment of Risk and Education (LungCARE) tool.
  • The LungCARE intervention involved a tablet-based educational assessment for patients in the waiting room, followed by a provider summary.
  • Participants were randomized to either the LungCARE intervention or usual care.

Key Points:

  • LungCARE participants showed significantly higher rates of LCS discussion (56% vs. 25%) and referral (44% vs. 13%) compared to usual care.
  • The intervention group also demonstrated increased LCS completion rates (32% vs. 13%) and improved LCS knowledge scores.
  • EHR review confirmed enhanced SDM conversations and LCS uptake in the LungCARE group.

Conclusions:

  • The LungCARE tool effectively increased patient-provider discussions regarding LCS.
  • LungCARE facilitated higher rates of LCS referral and completion among eligible primary care patients.
  • The intervention improved patient knowledge about lung cancer screening.