The 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

TELESCOPE Intervention Overview

Study Focus

The TELESCOPE intervention aims to improve shared decision-making (SDM) for lung cancer screening (LCS) through telehealth support by patient navigators. This is particularly important as LCS can lower lung cancer death rates but also poses some risks to patients. The Centers for Medicare & Medicaid Services (CMS) requires SDM discussions for LCS reimbursement.

Research Goal

This study will assess the effectiveness of the TELESCOPE intervention compared to standard care in primary care clinics.

Methodology

We will recruit 420 patients from 120 primary care clinicians for a randomized controlled trial. Participants will be divided into two groups:

  • TELESCOPE Group: Patients will receive telehealth decision coaching sessions about LCS before their clinic visit, guided by trained navigators. They will also receive a low-dose CT scan order if interested.
  • Enhanced Usual Care Group: Patients will receive standard care from their clinician, with additional resources like a webinar and LCS discussion guide.

Patients will complete surveys before and one week after their visit to evaluate the SDM process. Follow-ups will occur for those who haven’t completed their screenings. Additionally, patients with low-risk findings will randomly receive a follow-up coaching session or not.

Data Collection

Electronic health records will be reviewed at 6, 12, and 18 months to track LCS uptake, imaging results, further testing, cancer diagnoses, and treatment referrals.

Expected Outcomes

This study will determine if the decision coaching and navigation model supports effective SDM and promotes LCS uptake in busy primary care settings serving diverse populations.

Trial Registration

The study is registered at ClinicalTrials.gov (NCT05491213).

Clinical Trial Importance

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Operational Efficiency

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AI Benefits

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