对于肺癌查的初级保健外展和决策咨询
Heather Bittner Fagan1, Claudine Jurkovitz2, Zugui Zhang2
1Department of Family and Community Medicine, ChristianaCare Health Services, Inc., Wilmington, DE, USA.
Journal of medical screening
|November 22, 2023
概括
使用决策辅助的共享决策 (SDM) 提高了初级保健中肺癌查率. 这种干预措施有望增加查的普及率,尽管需要进行更大规模的研究.
科学领域:
- 公共卫生 公共卫生
- 预防医学 预防医学
- 临床试验研究 临床试验研究
背景情况:
- 肺癌查率仍然很低,尽管已建立的指导方针和已证明的死亡率降低.
- 共享决策 (SDM) 是医疗保险偿还肺癌查的要求.
- 查普及率较低,需要采取干预措施,以改善遵守指南的情况.
研究的目的:
- 评估一种新的SDM干预措施对初级保健机构肺癌查率的影响.
- 评估决策辅助工具在促进患者参与肺癌查方面的有效性.
- 为了确定SDM干预是否会增加低剂量计算机断层扫描 (LDCT) 扫描的完成率.
主要方法:
- 进行了一项单臂临床试验.
- 该干预涉及基于电话的外展和在线决策辅助 (决策咨询计划 ®) 以促进SDM.
- 测量的主要结果是干预后一年完成LDCT扫描.
主要成果:
- 在80名同意的患者中,64人完成了决策咨询会议.
- 在完成会议的人中,45%接受了LDCT查,这一比例高于通常观察到的.
- 拒绝决策咨询的16名患者中,没有一个接受LDCT扫描.
结论:
- 决策咨询似乎是一个有前途的干预措施,以支持SDM和提高肺癌查在初级保健采用.
- 该干预措施显示了改善遵守肺癌查建议的潜力.
- 需要使用更大的样本大小进行进一步的研究来证实这些发现.
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