CHEST Guidelines-In-person-and-Telephonic-Shared-Decision-making-Vi (1)

In-person-and-Telephonic-Shared-Decision-making-Vi (1)

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The study in the document evaluates shared decision-making (SDM) visit methodologies for lung cancer screening (LCS), focusing on patient satisfaction and decisional conflict when the SDM visit is conducted in-person or over the telephone. Conducted at the Medical University of South Carolina and Ralph H. Johnson Veterans Affairs Hospital, this prospective observational study included 137 participants who completed SDM visits and subsequent surveys.<br /><br />The analysis utilized the Ottawa Decision Support Framework to examine the effects of SDM on patient-provider communication, cultural beliefs, perceived benefits and harms of LCS, and the decision's impact, quality, and action. Participants were similar across demographic factors, but the telephonic group had more male participants.<br /><br />Results indicated that regardless of whether the SDM visit was conducted in person or by phone, patient satisfaction with their decision about LCS was high, and there was low decisional conflict. Approximately 88.3% of patients opted to undergo LCS, with no significant difference between the in-person (88.4%) and telephonic (88.2%) groups. <br /><br />This study is notable for being among the first to assess decision quality following an SDM visit for LCS. It found that both SDM delivery methods achieved high decision quality and impact, with most patients satisfied and experiencing minimal decisional conflict. Given the historically low LCS uptake, the study suggests that novel approaches, like telephonic SDM visits, might increase accessibility and convenience, thereby enhancing patient participation in LCS.<br /><br />Conclusively, incorporating SDM visits with tailored risk predictions and counseling, delivered either in-person or telephonically, can maintain high decision quality and satisfaction among patients considering lung cancer screening, suggesting viable alternatives to existing Medicare requirements for in-person visits.

Keywords

shared decision-making

lung cancer screening

patient satisfaction

decisional conflict

telephonic visits

Ottawa Decision Support Framework

patient-provider communication

decision quality

accessibility

Medicare requirements