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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| Format: | Article |
| Language: | English |
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BMC
2021-06-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-021-06551-9 |
| _version_ | 1819083567590801408 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Daniel M. Saman |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-21T20:34:37Z |
| format | Article |
| id | doaj.art-63af50e067f3402ab121363110a5f70a |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-21T20:34:37Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-63af50e067f3402ab121363110a5f70a2022-12-21T18:51:08ZengBMCBMC Health Services Research1472-69632021-06-0121111110.1186/s12913-021-06551-9The impact of personalized clinical decision support on primary care patients’ views of cancer prevention and screening: a cross-sectional surveyDaniel M. Saman0Ella A. Chrenka1Melissa L. Harry2Clayton I. Allen3Laura A. Freitag4Stephen E. Asche5Anjali R. Truitt6Heidi L. Ekstrom7Patrick J. O’Connor8JoAnn M. Sperl-Hillen9Jeanette Y. Ziegenfuss10Thomas E. Elliott11Nicklaus Children’s Health SystemHealthPartners InstituteEssentia Institute of Rural HealthEssentia Institute of Rural HealthEssentia Institute of Rural HealthHealthPartners InstituteHealthPartners InstituteHealthPartners InstituteHealthPartners InstituteHealthPartners InstituteHealthPartners InstituteHealthPartners InstituteAbstract 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.https://doi.org/10.1186/s12913-021-06551-9Cancer preventionCancer screeningClinical decision supportDecision aidElectronic health recordPatient survey |
| spellingShingle | 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 The impact of personalized clinical decision support on primary care patients’ views of cancer prevention and screening: a cross-sectional survey BMC Health Services Research Cancer prevention Cancer screening Clinical decision support Decision aid Electronic health record Patient survey |
| title | The impact of personalized clinical decision support on primary care patients’ views of cancer prevention and screening: a cross-sectional survey |
| title_full | The impact of personalized clinical decision support on primary care patients’ views of cancer prevention and screening: a cross-sectional survey |
| title_fullStr | The impact of personalized clinical decision support on primary care patients’ views of cancer prevention and screening: a cross-sectional survey |
| title_full_unstemmed | The impact of personalized clinical decision support on primary care patients’ views of cancer prevention and screening: a cross-sectional survey |
| title_short | The impact of personalized clinical decision support on primary care patients’ views of cancer prevention and screening: a cross-sectional survey |
| title_sort | impact of personalized clinical decision support on primary care patients views of cancer prevention and screening a cross sectional survey |
| topic | Cancer prevention Cancer screening Clinical decision support Decision aid Electronic health record Patient survey |
| url | https://doi.org/10.1186/s12913-021-06551-9 |
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