Shared Decision-Making in Colorectal Cancer Screening for Older Adults: A Secondary Analysis of a Cluster Randomized Clinical Trial
Summary
Deciding whether to stop colorectal cancer (CRC) screening tests in older adults can be challenging. This study evaluated the impact of physician training in shared decision-making (SDM) and electronic previsit reminders on the receipt of patient-preferred CRC screening approaches and overall screening rates for older adults.
Key Findings
Physicians in the intervention group completed an SDM training course and received previsit reminders, while those in the comparator group received reminders only. The study found that approximately half of older patients received their preferred approach to CRC screening. The training in SDM did not result in higher concordance rates overall but may have benefitted some subgroups, such as patients with a strong intention to follow through with their preferred approach and those who had more than 5 minutes of discussion with their primary care physician (PCP) regarding screening.
Implications
Future efforts to refine and evaluate clinical decision support and focused SDM skills training for PCPs may promote high-quality, preference-concordant decisions about CRC testing for older adults.
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