2D-5 CAN AN INTERACTIVE DECISION AID IMPROVE COLORECTAL CANCER SCREENING? OUTCOMES FROM THE DATES (DECISION AID TO TECHNOLOGICALLY ENHANCE SHARED DECISION MAKING) STUDY

Monday, October 24, 2016: 5:00 PM
Bayshore Ballroom Salon D, Lobby Level (Westin Bayshore Vancouver)

Masahito Jimbo, MD, PhD, MPH1, Ananda Sen, PhD1, Melissa Plegue, MA1, Sarah T. Hawley, PhD, MPH2, Karen Kelly-Blake, PhD3, Mary Rapai, MA1, Minling Zhang, MS1, Yuhong Zhang, BA1 and Mack Ruffin IV, MD, MPH1, (1)University of Michigan, Ann Arbor, MI, (2)University of Michigan, Ann Arbor VA Health System, Ann Arbor, MI, (3)Michigan State University, East Lansing, MI
Purpose: Colorectal cancer (CRC) screening remains underutilized. An interactive decision aid (DA) that clarifies patient risk and preferences may increase CRC screening rate. We determined the effect of a DA that provides interactive tools to assess risk and clarify preference for CRC screening options of stool blood test or colonoscopy on CRC screening adherence. 

Method: A two-armed randomized controlled trial funded by the National Cancer Institute (R01CA152413) was performed in twelve community and three university-based primary care practices in Metro Detroit. Participants were patients in these practices, men and women aged 50 to 75 years not current on CRC screening. Patients arriving to the practices for the scheduled visit were randomized, just prior to their face-to-face encounter with their clinician, to either a DA with interactive patient risk assessment and preference clarification tools in selecting a CRC screening test option (Intervention Arm) or to a DA that matched in content without interactive tools (Control Arm). Patient surveys were taken immediately before and after the DA use, and immediately after their clinician encounter. All web use and data collection was done in office. Primary outcome was medical record documentation of CRC screening six months after the office visit. Secondary outcomes were patient decision quality (knowledge, preference clarification, intent) obtained from the abovementioned surveys. 

Result: Among 549 participants (Intervention: 275; Control: 274), mean age was 57.7 years, 56.5% were women, and 54.5% were white and 37.3% black. Baseline knowledge, attitude, self-efficacy, test preference, and intent were similar between the two arms. At six months, CRC screening rate was 36.1% (95% confidence interval: 30.5-42.2%) in the Intervention Arm and 40.5% (95% confidence interval: 34.7-46.6%) in the Control Arm (p=0.29). Knowledge, attitude, self-efficacy, test preference, and intent increased in both arms after the DA use compared to the baseline. There was no significant difference between the two arms. 

Conclusion: A DA that incorporated interactive patient risk assessment and preference clarification tools did not increase the CRC screening rate at six months compared to a DA that matched in content but did not provide the interactive tools.

See more of: ORAL ABSTRACTS: CANCER SCREENING: PATIENT DECISIONS, PREFERENCES AND SUPPORT

See more of: 38th Annual North American Meeting of the Society for Medical Decision Making