Increasing lung cancer screening referral/order and completion rates in primary care through patient outreach and shared decision making

Objective This study tested methods to increase lung cancer screening referral/order and completion rates in primary care. Methods Patients identified via the electronic medical record as potentially lung cancer screening eligible were randomized either to a telephone outreach and decision counseling Group ( N = 506) or a usual care Group ( N = 2066). We evaluated intervention and covariate effects overall and assessed outcomes among telephone outreach and decision counseling Group patients verified as eligible ( n = 55), comparing rates of those who had decision counseling (OC + DC Group, n = 24) and who did not (OC−DC Group, n = 31). Results Telephone outreach and decision counseling Group lung cancer screening referral/order and completion rates were higher than usual care Group rates (16% and 9%, respectively, OR = 1.82, CI: 1.37, 2.41) and (8% and 6%, respectively, OR = 1.45, CI: 0.999, 2.09) and rates were higher among older and currently smoking patients (OR = 1.18, CI: 0.999, 1.40 and OR = 3.09, CI: 2.36, 4.05, respectively and OR = 1.32, CI: 1.06, 1.65 and OR = 2.78, CI: 1.98, 3.92, respectively). Among eligible patients, the lung cancer screening referral/order rate was much higher in the OC + DC Group versus OC−DC Group (96% and 42%, respectively, RR = 2.28, CI: 1.50, 3.49) and the lung cancer screening completion rate was somewhat higher (46% and 36%, respectively, RR = 1.29, CI: 0.68, 2.46). Conclusion Findings suggest that patient outreach and decision counseling may increase lung cancer screening rates in primary care.