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

Clayton I. Allen¹  Melissa L. Harry¹  Laura A. Freitag¹  Thomas E. Elliott²  Jeanette Y. Ziegenfuss²  JoAnn M. Sperl-Hillen²  Heidi L. Ekstrom²  Patrick J. O’Connor²  Anjali R. Truitt²  Ella A. Chrenka²  Stephen E. Asche²  Daniel M. Saman³ 

[1] Essentia Institute of Rural Health, 502 E. Second Street, 55805, Duluth, MN, USA;HealthPartners Institute, 3311 E. Old Shakopee Road, 55425, Bloomington, MN, USA;Nicklaus Children’s Health System, 3601 NW 107th Ave, 33178, Doral, FL, USA;Essentia Institute of Rural Health, 502 E. Second Street, 55805, Duluth, MN, USA;

关键词: Cancer prevention;    Cancer screening;    Clinical decision support;    Decision aid;    Electronic health record;    Patient survey;   

DOI  :  10.1186/s12913-021-06551-9

来源: Springer

【 摘 要 】

BackgroundFew 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.MethodsWe 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.ResultsOf 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).ConclusionsMost 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 registrationclinicaltrials.gov, NCT02986230, December 6, 2016.

【 授权许可】

CC BY