The impact of personalized clinical decision support on primary care patients’ views of cancer prevention and screening: a cross-sectional survey

BACKGROUND: Few studies have assessed the impact of clinical decision support (CDS), with or without shared decision-making tools (SDMTs), on patients’ perceptions of cancer screening or prevention in primary care settings. This cross-sectional survey was conducted to understand primary care patient...

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Detalles Bibliográficos
Autores principales: Saman, Daniel M., Chrenka, Ella A., Harry, Melissa L., Allen, Clayton I., Freitag, Laura A., Asche, Stephen E., Truitt, Anjali R., Ekstrom, Heidi L., O’Connor, Patrick J., Sperl-Hillen, JoAnn M., Ziegenfuss, Jeanette Y., Elliott, Thomas E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Research Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215810/
https://www.ncbi.nlm.nih.gov/pubmed/34154588
http://dx.doi.org/10.1186/s12913-021-06551-9
Descripción
Sumario:BACKGROUND: Few studies have assessed the impact of clinical decision support (CDS), with or without shared decision-making tools (SDMTs), on patients’ perceptions of cancer screening or prevention in primary care settings. This cross-sectional survey was conducted to understand primary care patient’s perceptions on cancer screening or prevention. METHODS: We mailed surveys (10/2018–1/2019) to 749 patients aged 18 to 75 years within 15 days after an index clinical encounter at 36 primary care clinics participating in a clinic-randomized control trial of a CDS system for cancer prevention. All patients were overdue for cancer screening or human papillomavirus vaccination. The survey compared respondents’ answers by study arm: usual care; CDS; or CDS + SDMT. RESULTS: Of 387 respondents (52% response rate), 73% reported having enough time to discuss cancer prevention options with their primary care provider (PCP), 64% reported their PCP explained the benefits of the cancer screening choice very well, and 32% of obese patients reported discussing weight management, with two-thirds reporting selecting a weight management intervention. Usual care respondents were significantly more likely to decide on colorectal cancer screening than CDS respondents (p < 0.01), and on tobacco cessation than CDS + SDMT respondents (p = 0.02) and both CDS and CDS + SDMT respondents (p < 0.001). CONCLUSIONS: Most patients reported discussing cancer prevention needs with PCPs, with few significant differences between the three study arms in patient-reported cancer prevention care. Upcoming research will assess differences in screening and vaccination rates between study arms during the post-intervention follow-up period. TRIAL REGISTRATION: clinicaltrials.gov, NCT02986230, December 6, 2016. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-06551-9.

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