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| Research article summary (published 30 Aug 2008): |
Informed decision-making and colorectal cancer screening: is it occurring in primary care?
Full Abstract
BACKGROUND:
Current recommendations advise patients to participate in the decision-making for selecting a colorectal cancer (CRC) screening option. The degree to which providers communicate the information necessary to prepare patients for participation in this process is not known.
OBJECTIVE:
To assess the level of informed decision-making occurring during actual patient-provider communications on CRC screening and test for the association between informed decision-making and screening behavior.
RESEARCH DESIGN:
Observational study of audiotaped clinic visits between patients and their providers in the primary care clinic at a Veterans Administration Medical Center.
SUBJECTS:
Male patients, age 50-74 years, presenting to a primary care visit at the study site.
MEASURES:
The Informed Decision-Making (IDM) Model was used to code the audiotapes for 9 elements of communication that should occur to prepare patients for participation in decision-making. The primary outcome is completion of CRC screening during the study period.
RESULTS:
The analytic cohort consisted of 91 patients due for CRC screening who had a test ordered at the visit. Six of the 9 IDM elements occurred in < or =20% of the visits with none addressed in > or =50%. CRC screening occurred less frequently for those discussing "pros and cons" (12% vs. 46%, P = 0.01) and "patient preferences" (6% vs. 47%, P = 0.001) compared with those who did not.
CONCLUSIONS:
We found that a lack of informed decision-making occurred during CRC screening discussions and that particular elements of the process were negatively associated with screening. Further research is needed to better understand the effects of informed decision-making on screening behavior.
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Author information
Author/s: Ling, Bruce S (BS); Trauth, Jeanette M (JM); Fine, Michael J (MJ); Mor, Maria K (MK); Resnick, Abby (A); Braddock, Clarence H (CH); Bereknyei, Sylvia (S); Weissfeld, Joel L (JL); Schoen, Robert E (RE); Ricci, Edmund M (EM); Whittle, Jeffrey (J);
Affiliation: VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania 15213, USA. lingbs(-atsign-)upmc.edu
Grants: 5K07 CA090359 (Agency:United States NCI) ; 5P01 HS10864 (Agency:United States AHRQ)
Journal and publication information
Publication Type: Journal Article; Research Support, N.I.H., Extramural
Journal: Medical care (Med Care), published in United States. (Language: eng)
Reference: 2008-Sep; vol 46 (issue 9 Suppl 1) : pp S23-9
Dates: Created 2008/08/26; Completed 2008/09/25;
PMID: 18725829, status: MEDLINE (last retrieval date: 11/6/2008)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
Comments and Corrections
CommentIn: Med Care. 2008 Sep;46(9 Suppl 1):S5-9. (PMID: 18725833)
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