Lung Cancer
Conditions
Brief summary
Lung cancer screening rates are very low despite the fact that lung cancer screening could save many lives. People need to understand the risks and benefits to screening as well as their own beliefs about screening. This study builds an intervention in real world primary care that will help people make the right decision for them as well as help people to quit smoking. Interventions like this are needed to improve the screening rate and reduce death from lung cancer, which is the leading cancer killer.
Detailed description
Lung cancer screening rates in the United States are very low- just 3.3% in 2010 and 3.9% in 2015. There is a critical need to develop and implement effective strategies to engage high-risk patients in a coordinated program of lung cancer screening, which includes shared-decision making. The investigators proposed to modify and expand a shared decision- counseling intervention previously developed in one primary care practice. The investigators measured lung cancer screening in our intervention group compared to a propensity-matched usual care cohort. The investigators compared patients recruited to patients who are not in order to identify potential sources of disparity in future work and the investigators developed a more intense smoking cessation component. Model interventions for shared-decision making in clinical practice are needed across a wide range of diseases and decisions.
Interventions
BEHAVIORALShared Decision Making
Telephone delivered non-persuasive shared decision-making for lung cancer screening.
Sponsors
Thomas Jefferson University
University of Delaware
National Institute of General Medical Sciences (NIGMS)
Christiana Care Health Services
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
55 Years to 78 Years
Healthy volunteers
Yes
Inclusion criteria
* Current or former smoker * Greater than or equal to 30 pack years smoking
Exclusion criteria
* Prior CT in last year * Quit smoking greater than 15 years ago * Current diagnosis of lung cancer
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Patients Who Received a Low Dose CT Scan of the Chest | 1 year | Percentage of individuals who have evidence of a low-dose CT scan of the chest in their electronic medical record at 1 year post intervention, as ascertained by chart audit by research assistance. |
Countries
United States
Participant flow
Recruitment details
We identified 1359 individuals in our electronic medical record data who appeared to be current smokers within the age range of 55-78 years old. From this group, 1073 remained potentially eligible after chart review. From this group, 336 were reached by phone. From this group, 80 individuals were eligible and consented to be in our study.
Participants by arm
| Arm | Count |
|---|---|
| Phone-delivered Decision-counseling Program for Shared Decision Making in Lung Cancer Screening All individuals who are eligible for lung cancer screening according to USPSTF criteria were invited to participate in the study and all patients who accepted the invitation and consented were slated to receive the intervention which was a phone-delivered on line decision-counseling program (DCP) and there was no one randomized or enrolled into a control group, nor was anyone randomized or enrolled into a usual care group.
Shared Decision Making: Telephone delivered non-persuasive shared decision-making for lung cancer screening. | 80 |
| Total | 80 |
Baseline characteristics
| Characteristic | Phone-delivered Decision-counseling Program for Shared Decision Making in Lung Cancer Screening |
|---|---|
| Age, Continuous | 64.1 years STANDARD_DEVIATION 6 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 79 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 1 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| pack-years | 45.6 (packs/day)*years STANDARD_DEVIATION 16.1 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 14 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 66 Participants |
| Sex: Female, Male Female | 40 Participants |
| Sex: Female, Male Male | 40 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 80 |
| other Total, other adverse events | 0 / 80 |
| serious Total, serious adverse events | 0 / 80 |
Outcome results
Primary
Number of Patients Who Received a Low Dose CT Scan of the Chest
Percentage of individuals who have evidence of a low-dose CT scan of the chest in their electronic medical record at 1 year post intervention, as ascertained by chart audit by research assistance.
Time frame: 1 year
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Phone-delivered Decision-counseling Program for Shared Decision Making in Lung Cancer Screening | Number of Patients Who Received a Low Dose CT Scan of the Chest | 18 Participants |