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Getting patients back for routine colorectal cancer screening: Randomized controlled trial of a shared decision‐making intervention

Thousands of colonoscopies were canceled during the initial surge of the COVID‐19 pandemic. As facilities resumed services, some patients were hesitant to reschedule. The purpose of this study was to determine whether a decision aid plus telephone coaching would increase colorectal cancer (CRC) scre...

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Autores principales: Sepucha, Karen R., Valentine, Kathrene D., Atlas, Steven J., Chang, Yuchiao, Fairfield, Kathleen M., Ha, Jasmine, Leavitt, Lauren, Lee, Vivian, Percac‐Lima, Sanja, Richter, James M., Simmons, Leigh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939149/
https://www.ncbi.nlm.nih.gov/pubmed/36052811
http://dx.doi.org/10.1002/cam4.5172
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author Sepucha, Karen R.
Valentine, Kathrene D.
Atlas, Steven J.
Chang, Yuchiao
Fairfield, Kathleen M.
Ha, Jasmine
Leavitt, Lauren
Lee, Vivian
Percac‐Lima, Sanja
Richter, James M.
Simmons, Leigh
author_facet Sepucha, Karen R.
Valentine, Kathrene D.
Atlas, Steven J.
Chang, Yuchiao
Fairfield, Kathleen M.
Ha, Jasmine
Leavitt, Lauren
Lee, Vivian
Percac‐Lima, Sanja
Richter, James M.
Simmons, Leigh
author_sort Sepucha, Karen R.
collection PubMed
description Thousands of colonoscopies were canceled during the initial surge of the COVID‐19 pandemic. As facilities resumed services, some patients were hesitant to reschedule. The purpose of this study was to determine whether a decision aid plus telephone coaching would increase colorectal cancer (CRC) screening and improve patient reports of shared decision making (SDM). A randomized controlled trial assigned adults aged 45–75 without prior history of CRC who had a colonoscopy canceled from March to May 2020 to intervention (n = 400) or usual care control (n = 400) arms. The intervention arm received three‐page decision aid and call from decision coach from September 2020 through November 2020. Screening rates were collected at 6 months. A subset (n = 250) in each arm was surveyed 8 weeks after randomization to assess SDM (scores range 0–4, higher scores indicating more SDM), decisional conflict, and screening preference. The sample was on average, 60 years old, 53% female, 74% White, non‐Hispanic, and 11% Spanish speaking. More intervention arm patients were screened within 6 months (35% intervention vs 23% control, p < 0.001). The intervention respondents reported higher SDM scores (mean difference 0.7 [0.4, 0.9], p < 0.001) and less decisional conflict than controls (−21% [−35%, −7%], p = 0.003). The majority in both arms preferred screening versus delaying (68% intervention vs. 65% control, p = 0.75). An SDM approach that offered alternatives and incorporated patients' preferences resulted in higher screening rates. Patients who are overdue for CRC screening may benefit from proactive outreach with SDM support.
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spelling pubmed-99391492023-02-20 Getting patients back for routine colorectal cancer screening: Randomized controlled trial of a shared decision‐making intervention Sepucha, Karen R. Valentine, Kathrene D. Atlas, Steven J. Chang, Yuchiao Fairfield, Kathleen M. Ha, Jasmine Leavitt, Lauren Lee, Vivian Percac‐Lima, Sanja Richter, James M. Simmons, Leigh Cancer Med RESEARCH ARTICLES Thousands of colonoscopies were canceled during the initial surge of the COVID‐19 pandemic. As facilities resumed services, some patients were hesitant to reschedule. The purpose of this study was to determine whether a decision aid plus telephone coaching would increase colorectal cancer (CRC) screening and improve patient reports of shared decision making (SDM). A randomized controlled trial assigned adults aged 45–75 without prior history of CRC who had a colonoscopy canceled from March to May 2020 to intervention (n = 400) or usual care control (n = 400) arms. The intervention arm received three‐page decision aid and call from decision coach from September 2020 through November 2020. Screening rates were collected at 6 months. A subset (n = 250) in each arm was surveyed 8 weeks after randomization to assess SDM (scores range 0–4, higher scores indicating more SDM), decisional conflict, and screening preference. The sample was on average, 60 years old, 53% female, 74% White, non‐Hispanic, and 11% Spanish speaking. More intervention arm patients were screened within 6 months (35% intervention vs 23% control, p < 0.001). The intervention respondents reported higher SDM scores (mean difference 0.7 [0.4, 0.9], p < 0.001) and less decisional conflict than controls (−21% [−35%, −7%], p = 0.003). The majority in both arms preferred screening versus delaying (68% intervention vs. 65% control, p = 0.75). An SDM approach that offered alternatives and incorporated patients' preferences resulted in higher screening rates. Patients who are overdue for CRC screening may benefit from proactive outreach with SDM support. John Wiley and Sons Inc. 2022-09-02 /pmc/articles/PMC9939149/ /pubmed/36052811 http://dx.doi.org/10.1002/cam4.5172 Text en © 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle RESEARCH ARTICLES
Sepucha, Karen R.
Valentine, Kathrene D.
Atlas, Steven J.
Chang, Yuchiao
Fairfield, Kathleen M.
Ha, Jasmine
Leavitt, Lauren
Lee, Vivian
Percac‐Lima, Sanja
Richter, James M.
Simmons, Leigh
Getting patients back for routine colorectal cancer screening: Randomized controlled trial of a shared decision‐making intervention
title Getting patients back for routine colorectal cancer screening: Randomized controlled trial of a shared decision‐making intervention
title_full Getting patients back for routine colorectal cancer screening: Randomized controlled trial of a shared decision‐making intervention
title_fullStr Getting patients back for routine colorectal cancer screening: Randomized controlled trial of a shared decision‐making intervention
title_full_unstemmed Getting patients back for routine colorectal cancer screening: Randomized controlled trial of a shared decision‐making intervention
title_short Getting patients back for routine colorectal cancer screening: Randomized controlled trial of a shared decision‐making intervention
title_sort getting patients back for routine colorectal cancer screening: randomized controlled trial of a shared decision‐making intervention
topic RESEARCH ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939149/
https://www.ncbi.nlm.nih.gov/pubmed/36052811
http://dx.doi.org/10.1002/cam4.5172
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