Increasing Uptake of Lung Cancer Screening Among Emergency Department Patients: A Pilot Study

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
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Abstract

Background

Lung cancer is the leading cause of cancer death in the United States. Lung cancer screening (LCS) decreases lung cancer mortality. Emergency department (ED) patients are at disproportionately high risk for lung cancer. The ED, therefore, is an optimal environment for interventions to promote LCS.

Objectives

Demonstrate the operational feasibility of identifying ED patients in need of LCS, referring them to LCS services, deploying a text message intervention to promote LCS, and conducting follow-up to determine LCS uptake.

Methods

We conducted a randomized clinical trial to determine the feasibility and provide estimates of the preliminary efficacies of 1) basic referral for LCS and 2) basic referral plus a text messaging intervention, grounded in behavioral change theory, to promote uptake of LCS among ED patients. Participants aged 50 to 80, identified as eligible for LCS, were randomized to study arms and followed up at 150 days to assess interval LCS uptake (primary outcome), barriers to screening, and perceptions of the study interventions.

Results

A total of 303 patients were surveyed, with 198 identified as eligible for LCS and subsequently randomized. Results indicated that 24% of participants with follow-up data received LCS (11% of the total randomized sample). Rates of screening at follow-up were similar across study arms. The intervention significantly improved normative perceptions of LCS (p = 0.015; Cohen's d = 0.45).

Conclusion

This pilot study demonstrates the feasibility of ED-based interventions to increase uptake of LCS among ED patients. A scalable ED-based intervention that increases LCS uptake could reduce lung cancer mortality.

提高急诊室患者的肺癌筛查率:一项试点研究
背景肺癌是美国癌症死亡的主要原因。肺癌筛查(LCS)可降低肺癌死亡率。急诊科(ED)患者罹患肺癌的风险极高。因此,急诊室是采取干预措施促进肺癌筛查的最佳环境。目标展示识别需要肺癌筛查的急诊室患者、将他们转介到肺癌筛查服务机构、部署短信干预措施促进肺癌筛查以及进行随访以确定肺癌筛查接受率的操作可行性。方法我们进行了一项随机临床试验,以确定以下两种方法的可行性,并对其初步疗效进行估算:1)基本转诊以接受 LCS 服务;2)基本转诊加短信干预(以行为改变理论为基础),以促进急诊室患者接受 LCS 服务。年龄在 50 至 80 岁之间、被确定为符合 LCS 条件的参与者被随机分配到研究组,并在 150 天后进行随访,以评估 LCS 的接受间隔(主要结果)、筛查障碍以及对研究干预措施的看法。结果 共调查了 303 名患者,其中 198 人被确定为符合 LCS 条件,随后被随机分配。结果显示,有随访数据的参与者中有 24% 接受了 LCS(占随机样本总数的 11%)。各研究机构的随访筛查率相似。该干预措施极大地改善了患者对 LCS 的标准认知(p = 0.015;Cohen's d = 0.45)。以急诊室为基础的可扩展干预措施可提高肺癌患者对肺癌筛查的接受率,从而降低肺癌死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Emergency Medicine
Journal of Emergency Medicine 医学-急救医学
CiteScore
2.40
自引率
6.70%
发文量
339
审稿时长
2-4 weeks
期刊介绍: The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine
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