Photo Credit: Yaroslav Olieinikov
The following is a summary of the study protocol “TELEhealth Shared decision-making COaching and navigation in Primary carE (TELESCOPE) intervention: a study protocol for delivering shared decision-making for lung cancer screening by patient navigators,” published in Primary Care in October 2024 by Tan et al.
Lung cancer screening (LCS) has the potential to reduce lung cancer mortality, but it also poses risks for patients. To ensure patients make informed decisions, the Centers for Medicare & Medicaid Services (CMS) mandates shared decision-making (SDM) for LCS reimbursement. However, incorporating SDM into primary care can be challenging.
For a study, researchers want to outline a protocol for the TELESCOPE intervention, which employs telehealth decision coaching and navigation by trained patient navigators to support SDM for LCS in primary care settings. They aim to evaluate both the effectiveness of this intervention and its potential for implementation.
It is a cluster randomized controlled trial with a target of 420 patients and 120 primary care clinicians. Clinicians are randomly assigned to one of two groups.
TELESCOPE intervention group: Patients participate in a telehealth session on LCS decision-making with a patient navigator before a non-acute clinic visit. If the patient opts for screening, a low-dose CT (LDCT) scan order is placed.
Enhanced usual care (EUC) group: Patients receive enhanced usual care, where clinicians are provided with Continuing Medical Education (CME) materials on LCS and a guide for discussing LCS with patients.
Patients will complete surveys before their clinic visit and one week after to evaluate the quality of the SDM process. If patients in the TELESCOPE group do not undergo LDCT within three months, re-navigation is attempted.
Patients whose initial LCS results are low-risk will be randomly assigned to receive either a telehealth decision coaching booster or no booster one month before their next annual screening.
Data will be collected from electronic health records over 18 months to assess screening uptake, imaging results, follow-up for abnormal findings, cancer diagnoses, and referrals for tobacco treatment.
The study will use mixed methods to explore factors that impact the success or failure of program implementation. By evaluating the TELESCOPE intervention, the study seeks to determine if telehealth decision coaching and navigation can effectively improve SDM and increase LCS uptake in diverse primary care practices.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02610-2
