A Protocol for a Cluster Randomized Trial of Care Delivery Models to Improve the Quality of Smoking Cessation and Shared Decision Making for Lung Cancer Screening

Authors

Lisa M Lowenstein
Ya-Chen Tina Shih
Jennifer Minnix
Maria A Lopez-Olivo
Kristin G Maki
George Kypriotakis
Viola B Leal
Sanjay S Shete
James Fox
Shawn P Nishi
Paul M Cinciripini
Robert J Volk

Publication Date

5-1-2023

Journal

Contemporary Clinical Trials

Abstract

BACKGROUND: Patients eligible for lung cancer screening (LCS) are those at high risk of lung cancer due to their smoking histories and age. While screening for LCS is effective in lowering lung cancer mortality, primary care providers are challenged to meet beneficiary eligibility for LCS from the Centers for Medicare & Medicaid Services, including a patient counseling and shared decision-making (SDM) visit with the use of patient decision aid(s) prior to screening.

METHODS: We will use an effectiveness-implementation type I hybrid design to: 1) identify effective, scalable smoking cessation counseling and SDM interventions that are consistent with recommendations, can be delivered on the same platform, and are implemented in real-world clinical settings; 2) examine barriers and facilitators of implementing the two approaches to delivering smoking cessation and SDM for LCS; and 3) determine the economic implications of implementation by assessing the healthcare resources required to increase smoking cessation for the two approaches by delivering smoking cessation within the context of LCS. Providers from different healthcare organizations will be randomized to usual care (providers delivering smoking cessation and SDM on site) vs. centralized care (smoking cessation and SDM delivered remotely by trained counselors). The primary trial outcomes will include smoking abstinence at 12-weeks and knowledge about LCS measured at 1-week after baseline.

CONCLUSION: This study will provide important new evidence about the effectiveness and feasibility of a novel care delivery model for addressing the leading cause of lung cancer deaths and supporting high-quality decisions about LCS.

Trial Registration: ClinicalTrials.gov NCT04200534

Keywords

Aged, Humans, United States, Smoking Cessation, Lung Neoplasms, Decision Making, Shared, Early Detection of Cancer, Medicare, Delivery of Health Care, Decision Making, Randomized Controlled Trials as Topic

Comments

Associated Data

PMID: 36878389