Individual- and neighborhood-level characteristics of lung cancer screening participants undergoing telemedicine shared decision making

BMC Health Services Research

Research

Hee-Soon Juon¹  Charnita Zeigler-Johnson¹  Julie A. Barta²  Gregory C. Kane²  Brooke Ruane²  Christine S. Shusted²  Brian Till³  Nathaniel R. Evans³  Olugbenga Okusanya³  Tyler Grenda³  Russell K. McIntire⁴ 

[1] Department of Medical Oncology, Division of Population Science, Thomas Jefferson University, 19107, Philadelphia, PA, USA;Division of Pulmonary and Critical Care Medicine, The Jane and Leonard Korman Respiratory Institute at Thomas Jefferson University, 834 Walnut Street, Suite 650, 19107, Philadelphia, PA, USA;Division of Thoracic Surgery, The Jane and Leonard Korman Respiratory Institute at Thomas Jefferson University, 19107, Philadelphia, PA, USA;Jefferson College of Population Health, Thomas Jefferson University, 19107, Philadelphia, PA, USA;

关键词: Lung cancer screening;    Telemedicine;    Health disparities;    Lung cancer;    Screening adherence;   

DOI  :  10.1186/s12913-023-10185-4

 received in 2022-11-10, accepted in 2023-10-19,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAlthough lung cancer screening (LCS) for high-risk individuals reduces lung cancer mortality in clinical trial settings, many questions remain about how to implement high-quality LCS in real-world programs. With the increasing use of telemedicine in healthcare, studies examining this approach in the context of LCS are urgently needed. We aimed to identify sociodemographic and other factors associated with screening completion among individuals undergoing telemedicine Shared Decision Making (SDM) for LCS.MethodsThis retrospective study examined patients who completed Shared Decision Making (SDM) via telemedicine between May 4, 2020 – March 18, 2021 in a centralized LCS program. Individuals were categorized into Complete Screening vs. Incomplete Screening subgroups based on the status of subsequent LDCT completion. A multi-level, multivariate model was constructed to identify factors associated with incomplete screening.ResultsAmong individuals undergoing telemedicine SDM during the study period, 20.6% did not complete a LDCT scan. Bivariate analysis demonstrated that Black/African-American race, Medicaid insurance status, and new patient type were associated with greater odds of incomplete screening. On multi-level, multivariate analysis, individuals who were new patients undergoing baseline LDCT or resided in a census tract with a high level of socioeconomic deprivation had significantly higher odds of incomplete screening. Individuals with a greater level of education experienced lower odds of incomplete screening.ConclusionsAmong high-risk individuals undergoing telemedicine SDM for LCS, predictors of incomplete screening included low education, high neighborhood-level deprivation, and new patient type. Future research should focus on testing implementation strategies to improve LDCT completion rates while leveraging telemedicine for high-quality LCS.

【 授权许可】

CC BY   
© The Author(s) 2023

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