Alison Brenner, PhD, MPH, deputy director of research for the Decision Support Lab at the Cecil G Sheps Center for Health Services, was first author and Dan Reuland, MD, MPH, a UNC Lineberger member and professor in the UNC School of Medicine, was senior author of a paper published in the American Journal of Preventive Medicine. Multiple other UNC researchers were collaborators on the study, called “Colorectal Cancer Screening in Vulnerable Patients.”
Researchers wanted to gauge whether the use of a screening decision aid could improve communication between physicians and vulnerable patients about colorectal cancer screening. They found that a decision aid that’s available in English and in Spanish, and used before primary care visits, could improve patient-reported communications and decision making outcomes in a racially and ethnically divers safety net clinical population.
They wanted to attack the problem because patients with low income, who have low literacy and limited English proficiency have low colorectal cancer screening rates.
“When appropriately informed, primary care patients have distinct preferences for screening tests and are more likely to complete screening when their provider recommends a screening test that they prefer,” Brenner said. “However, studies also show that patients and physicians often have different screening test preferences, physicians are more likely than patients to prefer colonoscopy over stool-based tests, and physicians often misperceive or fail to acknowledge patients’ screening preferences, especially when they differ from their own.”
Brenner said that suggests that improving informed decision making through improved patient knowledge about CRC screening options, as well as shared decision making, through physician offering of a choice of tests and incorporation of patient test preference into the recommendation, may be effective at overcoming some barriers to screening.