Low-Dose CT Lung Cancer Screening Practices and Attitudes Among Primary Care Providers at an Academic Medical Center

Author(s):  
J. Lewis ◽  
W.J. Petty ◽  
J.A. Tooze ◽  
D.P. Miller ◽  
C. Chiles ◽  
...  
2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S523-S524
Author(s):  
Genevieve Allen ◽  
Jamie Riddell

Abstract Background HIV remains a problem for adolescents with 21% of new infections in the United States in 2018 occurring in youth. In this study we attempted to assess the knowledge of and comfort with pre-exposure prophylaxis and universal HIV testing among adolescent primary care providers affiliated with one academic medical center. Methods We conducted a survey of internal medicine/pediatrics, pediatrics, and family medicine residents and attending physicians affiliated with an academic medical center. Data collected included provider prescribing and referring habits for PrEP and information on their universal HIV testing habits. A “test your knowledge” section followed the survey which asked participants to name PrEP medications and to correctly select laboratory monitoring required for PrEP. Correct answers and prescribing resources were provided on completion of the survey. Results 138 (76%) respondents were aware that PrEP is approved for adolescents. There was no significant difference across specialties or between residents and attendings. 44.8% of respondents felt uncomfortable prescribing PrEP and two thirds had never prescribed PrEP. Reasons for not prescribing PrEP included: not seeing adolescents who qualify (n=80), not having enough training (66), confidentiality concerns (22), forgetting to address PrEP (19), and concern incidence of HIV is too low to recommend PrEP (15). Pediatricians were the least likely to test for HIV with 11% of pediatrician, 32% of internal medicine/pediatric, and 38% of family medicine respondents reported universal HIV testing for patients 15 years and older (p < 0.05). Residents were more likely to test for HIV than attendings (33.3% versus 16%, p < 0.05). 111 participants completed the “test your knowledge” section. 31.5% correctly named two approved PrEP medications. There were 183 responses to the survey (49% response rate). Conclusion Adolescent primary care providers are aware that PrEP is FDA approved for adolescents but a gap in PrEP prescribing and HIV testing persists. There remain perceptions that HIV incidence is too low to discuss PrEP and that providers are not seeing patients who qualify. Next steps include developing an institutional PrEP guideline and creating an electronic medical record order set to facilitate PrEP prescribing. Disclosures All Authors: No reported disclosures


2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 191-191
Author(s):  
Katie Marsh ◽  
Mikael Anne Greenwood-Hickman ◽  
Laura Jones ◽  
M. Patricia Rivera ◽  
J. Michael Bowling ◽  
...  

191 Background: In response to the National Lung Screening Trial’s findings, numerous professional organizations have published guidelines recommending annual lung cancer (LC) screening with low dose computed tomography (LDCT) for eligible patients. In the wake of these guidelines, we sought to assess LC screening practices and beliefs among providers at a large academic medical center. Methods: In 2015, we surveyed 54 physicians and 9 residents in pulmonology (27% response rate) and 86 physicians and 100 residents in family/internal medicine (39% response rate). The 23 question Qualtrics survey focused on beliefs and knowledge about LC screening recommendations, guidelines, and practices. Results: Survey respondents in both groups were mostly White non-Hispanic clinicians with a mean age of 40 (range 28-67). Pulmonology respondents were mostly male (69%) and family/internal medicine respondents were mostly female (53%). The pulmonology group was more likely than family/internal medicine to believe that LC screening is beneficial for patients (p < 0.0001) and cost effective (p = 0.02). Over 76% of the pulmonology group reported ordering a LDCT for an asymptomatic patient in the past 12 months compared to 41% in the family/internal medicine group (p = 0.012). Additionally, 76% in pulmonology were aware of the American College of Chest Physicians recommendations versus 38% in family/internal medicine (p = 0.02). The majority of both groups agreed that an electronic prompt would increase the likelihood of referring a patient for LC screening. While both groups agreed that a LC screening registry would benefit the quality of patient care (100% pulmonology; 65% family/internal medicine; p = 0.02) and make them more likely to refer patients to a LC screening program (88%; 54%; p = 0.04), a significantly larger majority of the pulmonology group held these beliefs. Conclusions: Pulmonology respondents had more knowledge of guidelines and more favorable opinions of LC screening than family/internal medicine respondents. Our findings suggest future studies should focus on educating providers about recommendations and understanding why the family/internal medicine group is less likely to refer patients for LC screening.


2019 ◽  
Author(s):  
Lisa BE Shields ◽  
Jessica G Wilkett Barnes ◽  
Connie Buckley ◽  
George J Mikos ◽  
Katie N Rogers ◽  
...  

Abstract Background Lung cancer is the primary cause of cancer death in men and women in the USA, led by Kentucky. In 2015, the Centers for Medicare and Medicaid Services initiated annual lung cancer screening with a low-dose computed tomography (LDCT) scan. This observational cohort study evaluated the multidisciplinary approach to this screening in our metropolitan community. Methods We present the prospective findings of patients who underwent a screening lung LDCT scan over a 2-year period at our institution in Kentucky. Patients who fulfilled the screening criteria were identified during an office visit with their primary care provider. Results Of the 4170 patients who underwent a screening lung LDCT scan, a total of 838 (20.9%) patients had nodules >4 mm. Of the 70 patients diagnosed with lung cancer, Stage 1 non-small cell lung cancer was most commonly detected [38 cases (54.3%)]. A follow-up lung LDCT scan (n = 897), pulmonary function test (n = 157), positron emission tomography scan (n = 12) and a lung biopsy (n = 53) were performed for certain individuals who had anomalies observed on the screening lung LDCT scan. A total of 42% of patients enrolled in group tobacco cessation classes quit smoking. Conclusions This study provides a unique perspective of a lung LDCT scan screening program driven by primary care providers in a state plagued by cigarette smoking and lung cancer deaths and offers a valuable message into the prevention, high-risk screening and diagnosis of lung cancer.


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