Impact of the shared decision‐making process on lung cancer screening decisions

• Published in: Cancer medicine (Malden, MA) Vol. 11; no. 3; pp. 790 - 797
• Main Authors: Tan, Naomi Q. P., Nishi, Shawn P. E., Lowenstein, Lisa M., Mendoza, Tito R., Lopez‐Olivo, Maria A., Crocker, Laura C., Sepucha, Karen R., Volk, Robert J.
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01-02-2022; John Wiley and Sons Inc; Wiley
• Subjects: Cancer Prevention; Cancer screening; Clinical decision making; Cognitive ability; decision aids; Decision Making; Decision Making, Shared; Early Detection of Cancer; Education; Female; Gender; Humans; implementation science; Knowledge; Lung cancer; Lung Neoplasms - diagnosis; Male; Mass Screening; Medical screening; Middle Aged; Patients; Surveys and Questionnaires; Thoracic surgery; United States > US; lung cancer; cancer screening; decision aids; decision making, shared; implementation science
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.4445

Background
Professional organizations recommend the use of shared decision‐making (SDM) in supporting patients’ decisions about lung cancer screening (LCS). The objective of this study was to assess the impact of the SDM process on patient knowledge about LCS, decisional conflict, intentions to adhere to screening recommendations, and its role in how the patient made the final decision.
Methods
This study surveyed patients screened for lung cancer within 12 months of the survey, recruited from two academic tertiary care centers in the South Central Region of the U.S. (May to July 2018).
Results
Two hundred and sixty‐four patients completed the survey (87.9% White, 52% male, and mean age of 64.81). Higher SDM process scores (which indicates a better SDM process reported by patients) were significantly associated with greater knowledge of LCS (b = 0.17 p < 0.01). Higher SDM process scores were associated with less decisional conflict about their screening choice (b = 0.45, p < 0.001), greater intentions to make the same decision again (OR = 1.42, 95% CI = [1.06–1.89]), and greater intentions to undergo LCS again (OR = 1.32, 95% CI = [1.08–1.62]). The SDM process score was not associated with patients’ report of whether or not they shared the final decision with the healthcare provider (OR = 1.07, 95% CI = [0.85–1.35]).
Conclusion(s)
This study found that a better SDM process was associated with better affective‐cognitive outcomes among patients screened for lung cancer.
The impact of the shared decision‐making (SDM) process on patient outcomes in the context of lung cancer screening is understudied. This study found that a better SDM process was associated with greater knowledge of LCS, less decisional conflict, and intentions to adhere to LCS screening guidelines.