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  P2.11 - Screening and Early Detection (Not CME Accredited Session) (ID 960)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

  • 27148

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    P2.11-26 - First of its Kind Multi-Pronged Training for PCPs in an Epicenter of Lung Cancer – What Was Achieved in Two Years? (ID 14156)

    16:45 - 18:00  |  Presenting Author(s): Celeste T. Worth
    • Abstract
    • Slides

    Background
    

    Kentucky’s lung cancer (LC) rates have been the highest in the U.S. and amongst the highest in the world. Primary care provider (PCP) understanding and adoption of the U.S. Preventive Services Task Force (USPSTF) recommendation for LCS with low-dose CT (LDCT) were very low over a year after its release. LDCT is the only recommended tool for early detection of LC; making PCP education crucial for impacting the leading cause of cancer death.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    The Kentucky LEADS (Lung cancer Education Awareness Detection and Survivorship) Collaborative was initiated to reduce the LC burden through novel interventions to promote provider education (PE), survivorship care, and prevention/early detection. The PE component sought to improve referral of high-risk patients to LCS incorporating quality shared decision-making and tobacco cessation counseling through multi-pronged continuing education (CE) programs for PCPs statewide. Four unique interventions were developed, implemented, and evaluated: an interactive online course, didactic presentations with audience response system, academic detailing with a LEADS Primary Care Toolkit, and a webinar.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Participation in these CE programs was unprecedented including 1,400+ PCPs (more than 20% of the state’s total) and 2,700+ health professionals total. Participation based on platform type, provider discipline, specialty, and years in practice will be shared, as well as self-reported changes in practice behaviors as a result of the training(s) and feedback on which elements were of most value. A remarkable increase in LDCT scans in accredited facilities statewide for eligible patients after the intervention period will be discussed, as well as potential for lower numbers needed to screen for the early detection of LC in higher risk geographic areas, as compared to those for the National Lung Screening Trial (NLST), upon which the USPSTF recommendation was based.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Appropriate utilization of LCS must be an urgent and pervasive priority among referring providers. Limitations for screening such as LDCT availability, patient awareness and acceptance, and negative perceptions of treatment options are being diminished. However, PCP requirements for appropriate referral must be addressed for optimal utilization of this screening tool. These include provider understanding of recommendations, eligibility, and screening risks, benefits, and limitations, as well as knowledge of available screening facilities, reimbursement for shared decision making, screening coverage, and available resources. Adoption of new screening modalities by providers and patients alike always takes time, but education for referring providers is the “next big thing” in improving LC outcomes. It is imperative that it be comprehensive, appealing, innovative, and evidence-based.

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