• Chest · Mar 2017

    Impact of a Lung Cancer Screening Counseling and Shared-Decision-Making Visit.

    • Peter J Mazzone, Amanda Tenenbaum, Meredith Seeley, Hilary Petersen, Christina Lyon, Xiaozhen Han, and Xiao-Feng Wang.
    • Respiratory Institute, Cleveland Clinic, Cleveland, OH. Electronic address: mazzonp@ccf.org.
    • Chest. 2017 Mar 1; 151 (3): 572-578.

    BackgroundLung cancer screening is a complex balance of benefits and harms. A counseling and shared decision-making visit has been mandated to assist patients with the decision about participation in screening. To our knowledge, the impact of this visit on patient understanding and decisions has not been studied.MethodsWe developed a centralized counseling and shared decision-making visit for our lung cancer screening program. The visit included confirmation of eligibility for screening, education supported by a narrated slide show, individualized risk assessment with a decision aid, time for answering questions, and data collection. We surveyed consecutive patients prior to the visit, immediately after the visit, and 1 month after the visit to determine the impact of the visit on their knowledge.ResultsTwenty-three of 423 patients (5.4%) who had a visit did not proceed to the screening CT scan. One hundred twenty-five consecutive patients completed the initial survey, 122 completed the postvisit survey, and 113 completed the 1-month follow-up survey. Prior to the visit, the patients had a poor level of understanding about the age and smoking eligibility criteria (8.8% and 13.6% correct, respectively) and the benefits and harms of screening (55.2% and 38.4% correct, respectively). There was a significant improvement in knowledge noted after the visit for all questions (P = .03 to P < .0001). Knowledge waned by the 1-month follow-up but remained higher than it was before the visit.ConclusionsA centralized counseling and shared decision-making visit impacts the patient's knowledge about the eligibility criteria, benefits, and harms of lung cancer screening with LDCT, helping patients make value-based decisions.Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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