Clinician and patient perspectives on screening mammography among women age 75 and older: A pilot study of a novel decision aid
Objective: Supporting patient-clinician communication is key to implementing tailored, risk-based screening for older adults. Objectives of this multiphase mixed methods study were to identify factors that primary care clinicians consider influential when making screening mammography recommendations...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-12-01
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| Series: | PEC Innovation |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772628223000122 |
| _version_ | 1827919963581579264 |
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| author | Dejana Braithwaite Anthony Chicaiza Katherine Lopez Kenneth W. Lin Ranit Mishori Shama D. Karanth Stephen Anton Kristen Miller Mara A. Schonberg Nancy L. Schoenborn Suzanne C. O’Neill |
| author_facet | Dejana Braithwaite Anthony Chicaiza Katherine Lopez Kenneth W. Lin Ranit Mishori Shama D. Karanth Stephen Anton Kristen Miller Mara A. Schonberg Nancy L. Schoenborn Suzanne C. O’Neill |
| author_sort | Dejana Braithwaite |
| collection | DOAJ |
| description | Objective: Supporting patient-clinician communication is key to implementing tailored, risk-based screening for older adults. Objectives of this multiphase mixed methods study were to identify factors that primary care clinicians consider influential when making screening mammography recommendations for women ≥75 years, develop a patient decision aid that incorporates these factors, and gather feasibility and acceptability from the patients’ perspective. Methods: Clinicians from a Mid-Atlantic practice network completed online surveys. Women in the same network completed surveys before and after receiving a tailored booklet that included information about the benefits and harms of screening for women ≥ 75 years, a breast cancer risk-estimate, and a question prompt list to support patient-clinician communication Results: Clinicians (N=21) were primarily women [57.1%] and practiced family medicine [81.0%]. They cited patients’ age ≥75 years [95.4%], comorbidity [86.4%], functional status [77.3%], cancer family history [63.6%], U.S. Preventive Services Task Force guidelines [81.8%] and new research [77.3%] as factors influencing their recommendations. Fourteen women completed baseline surveys and received personalized decision aids (Mean age=79.1 years). Eleven completed the post-intervention survey. All were satisfied with the booklet length, 81.8% found the booklet easy to understand and 72.7% helpful in decision-making Perceived lifetime breast cancer risk decreased significantly from pre- to post-intervention (p = 0.02). Conclusions: Results suggest this decision aid, which incorporates key decisional factors from the clinician's perspective, is feasible and acceptable to patients. Innovation: A tailored decision aid booklet is innovative as it provides information on personalized risk and potential benefits and harms to older women considering screening. |
| first_indexed | 2024-03-13T04:04:56Z |
| format | Article |
| id | doaj.art-1b032a76b60148fdbcc0319e127c7233 |
| institution | Directory Open Access Journal |
| issn | 2772-6282 |
| language | English |
| last_indexed | 2024-03-13T04:04:56Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | PEC Innovation |
| spelling | doaj.art-1b032a76b60148fdbcc0319e127c72332023-06-21T07:01:41ZengElsevierPEC Innovation2772-62822023-12-012100132Clinician and patient perspectives on screening mammography among women age 75 and older: A pilot study of a novel decision aidDejana Braithwaite0Anthony Chicaiza1Katherine Lopez2Kenneth W. Lin3Ranit Mishori4Shama D. Karanth5Stephen Anton6Kristen Miller7Mara A. Schonberg8Nancy L. Schoenborn9Suzanne C. O’Neill10University of Florida Health Cancer Center, Gainesville, FL, United States of America; Corresponding author at: University of Florida Health Cancer Center, University of Florida, Clinical and Translational Research Building, 2004 Mowry Road, Gainesville, FL 32610, United States of America.Georgetown University Medical Center, Washington, DC, United States of AmericaGeorgetown University Medical Center, Washington, DC, United States of AmericaGeorgetown University Medical Center, Washington, DC, United States of AmericaGeorgetown University Medical Center, Washington, DC, United States of AmericaUniversity of Florida Health Cancer Center, Gainesville, FL, United States of AmericaUniversity of Florida Health Cancer Center, Gainesville, FL, United States of AmericaGeorgetown University Medical Center, Washington, DC, United States of America; National Center for Human Factors in Healthcare, MedStar Health Research Institute, Washington, DC, United States of AmericaDana Farber Cancer Center, Harvard University, Boston, MA, United States of AmericaJohns Hopkins University School of Medicine, Baltimore, MD, United States of AmericaGeorgetown University Medical Center, Washington, DC, United States of AmericaObjective: Supporting patient-clinician communication is key to implementing tailored, risk-based screening for older adults. Objectives of this multiphase mixed methods study were to identify factors that primary care clinicians consider influential when making screening mammography recommendations for women ≥75 years, develop a patient decision aid that incorporates these factors, and gather feasibility and acceptability from the patients’ perspective. Methods: Clinicians from a Mid-Atlantic practice network completed online surveys. Women in the same network completed surveys before and after receiving a tailored booklet that included information about the benefits and harms of screening for women ≥ 75 years, a breast cancer risk-estimate, and a question prompt list to support patient-clinician communication Results: Clinicians (N=21) were primarily women [57.1%] and practiced family medicine [81.0%]. They cited patients’ age ≥75 years [95.4%], comorbidity [86.4%], functional status [77.3%], cancer family history [63.6%], U.S. Preventive Services Task Force guidelines [81.8%] and new research [77.3%] as factors influencing their recommendations. Fourteen women completed baseline surveys and received personalized decision aids (Mean age=79.1 years). Eleven completed the post-intervention survey. All were satisfied with the booklet length, 81.8% found the booklet easy to understand and 72.7% helpful in decision-making Perceived lifetime breast cancer risk decreased significantly from pre- to post-intervention (p = 0.02). Conclusions: Results suggest this decision aid, which incorporates key decisional factors from the clinician's perspective, is feasible and acceptable to patients. Innovation: A tailored decision aid booklet is innovative as it provides information on personalized risk and potential benefits and harms to older women considering screening.http://www.sciencedirect.com/science/article/pii/S2772628223000122Breast cancer screeningOlder adultsPerson-centered decision-makingBenefits and harm |
| spellingShingle | Dejana Braithwaite Anthony Chicaiza Katherine Lopez Kenneth W. Lin Ranit Mishori Shama D. Karanth Stephen Anton Kristen Miller Mara A. Schonberg Nancy L. Schoenborn Suzanne C. O’Neill Clinician and patient perspectives on screening mammography among women age 75 and older: A pilot study of a novel decision aid PEC Innovation Breast cancer screening Older adults Person-centered decision-making Benefits and harm |
| title | Clinician and patient perspectives on screening mammography among women age 75 and older: A pilot study of a novel decision aid |
| title_full | Clinician and patient perspectives on screening mammography among women age 75 and older: A pilot study of a novel decision aid |
| title_fullStr | Clinician and patient perspectives on screening mammography among women age 75 and older: A pilot study of a novel decision aid |
| title_full_unstemmed | Clinician and patient perspectives on screening mammography among women age 75 and older: A pilot study of a novel decision aid |
| title_short | Clinician and patient perspectives on screening mammography among women age 75 and older: A pilot study of a novel decision aid |
| title_sort | clinician and patient perspectives on screening mammography among women age 75 and older a pilot study of a novel decision aid |
| topic | Breast cancer screening Older adults Person-centered decision-making Benefits and harm |
| url | http://www.sciencedirect.com/science/article/pii/S2772628223000122 |
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