Abstract
Objective
Our aim was to facilitate shared decision making (SDM) during preventive visits by utilizing a web-based survey system to offer colorectal cancer (CRC) and prostate cancer screening decision aids (DAs) to appropriately identified patients prior to the visit.
Methods
Patients completed a web-based questionnaire before their preventive medicine appointment. Age- and gender-appropriate patients completed additional questions to determine eligibility for CRC or prostate-specific antigen (PSA) screening. Eligible patients were offered a choice of video or print DA, and completed questions assessing their knowledge, values, and preferences regarding the screening decision. Responses were summarized and fed forward to clinician and patient reports.
Results
Overall, 11,493 CRC and 4,384 PSA questionnaires were completed. Patient responses were used to identify those eligible for cancer-screening DAs: 2,187 (19 %) for CRC and 2,962 (68 %) for PSA; 15 % of eligible patients requested a DA. Many patients declined a DA because they indicated they “already know enough to make their decision” (34 % for CRC, 46 % for PSA).
Conclusion
A web-based questionnaire provides an efficient means to identify patients eligible for cancer screening decisions and to offer them DAs before an appointment. Pre-visit use of DAs along with reports giving feedback to patients and clinicians provides an opportunity for SDM to occur at the visit.
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Acknowledgments and Conflicts of Interest
We wish to acknowledge the Informed Medical Decisions Foundation (IMDF) for their support of this work, and Drs. Dale Vidal and Blair Brooks for their advice and mentorship. The IMDF developed the DAs used in this study. Both authors have received grant and partial salary support from IMDF in the past.
Authors’ contributions
Both authors contributed substantially to the study including (i) the conception and design of the study, analysis and interpretation of data; (ii) drafting the article or revising it critically for important intellectual content; (iii) final approval of the version to be submitted (all authors). The corresponding author, Charles D. Brackett (cdb@hitchcock.org) is responsible for the integrity of the work as a whole.
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Brackett, C.D., Kearing, S. Use of a Web-Based Survey to Facilitate Shared Decision Making for Patients Eligible for Cancer Screening. Patient 8, 171–177 (2015). https://doi.org/10.1007/s40271-014-0079-7
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DOI: https://doi.org/10.1007/s40271-014-0079-7