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

Abstract 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...

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Main Authors: Daniel M. Saman, Ella A. Chrenka, Melissa L. Harry, Clayton I. Allen, Laura A. Freitag, Stephen E. Asche, Anjali R. Truitt, Heidi L. Ekstrom, Patrick J. O’Connor, JoAnn M. Sperl-Hillen, Jeanette Y. Ziegenfuss, Thomas E. Elliott
Format: Article
Language:English
Published: BMC 2021-06-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-021-06551-9
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Summary:Abstract 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.
ISSN:1472-6963