Patient navigation for lung cancer screening among current smokers in community health centers a randomized controlled trial
Patient navigation for lung cancer screening among current smokers in community health centers a randomized controlled trial
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DOI：
10.1002/cam4.1297
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发表时间：
2018-03-01
期刊：
影响因子：
4
通讯作者：
Atlas, Steven J.
中科院分区：
文献类型：
--
作者：
Percac-Lima, Sanja;Ashburner, Jeffrey M.;Atlas, Steven J.
每年进行一次胸部计算机断层扫描（CT）可以降低高危人群的肺癌死亡率。患者导航提高了服务不足人群的癌症筛查率。随机对照试验于2016年2月至2017年1月进行，以评估患者导航计划对隶属于学术初级保健网络的五个社区卫生中心（CHC）当前吸烟者肺癌筛查（LCS）的影响。我们将1200名年龄在55- 77岁的吸烟者随机分为干预组（n=400）和常规护理组（n=800）。导航员联系患者以确定LCS资格，介绍有关筛查的共同决策，安排与初级保健医生（PCP）的预约，并帮助克服获得筛查和随访的障碍。对照组患者接受常规护理。主要结局是进行胸部CT的患者比例。次要结果是联系的患者比例，接受LCS CT的比例，筛查结果和诊断的肺癌数量。在400名干预患者中，有335人获得联系，76人拒绝参与。在259名参与者中，124人（48%）不符合筛查条件; 119人吸烟
Annual chest computed tomography (CT) can decrease lung cancer mortality in high-risk individuals. Patient navigation improves cancer screening rates in underserved populations. Randomized controlled trial was conducted from February 2016 to January 2017 to evaluate the impact of a patient navigation program on lung cancer screening (LCS) among current smokers in five community health centers (CHCs) affiliated with an academic primary care network. We randomized 1200 smokers aged 55-77years to intervention (n=400) or usual care (n=800). Navigators contacted patients to determine LCS eligibility, introduce shared decision making about screening, schedule appointments with primary care physicians (PCPs), and help overcome barriers to obtaining screening and follow-up. Control patients received usual care. The main outcome was the proportion of patients who had any chest CT. Secondary outcomes were the proportion of patients contacted, proportion receiving LCS CTs, screening results and number of lung cancers diagnosed. Of the 400 intervention patients, 335 were contacted and 76 refused participation. Of the 259 participants, 124 (48%) were ineligible for screening; 119 had smoked