Clinician and patient perspectives on screening mammography among women age 75 and older: A pilot study of a novel decision aid

Dejana Braithwaite, Anthony Chicaiza, Katherine Lopez, Kenneth W. Lin, Ranit Mishori, Shama D. Karanth, Stephen Anton, Kristen Miller, Mara A. Schonberg, Nancy L. Schoenborn, Suzanne C. O'Neill

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Supporting patient-clinician communication is key to implementing tailored, risk-based screening for older adults. Objectives of this multiphase mixed methods study were to identify factors that primary care clinicians consider influential when making screening mammography recommendations for women ≥75 years, develop a patient decision aid that incorporates these factors, and gather feasibility and acceptability from the patients’ perspective. Methods: Clinicians from a Mid-Atlantic practice network completed online surveys. Women in the same network completed surveys before and after receiving a tailored booklet that included information about the benefits and harms of screening for women ≥ 75 years, a breast cancer risk-estimate, and a question prompt list to support patient-clinician communication Results: Clinicians (N=21) were primarily women [57.1%] and practiced family medicine [81.0%]. They cited patients’ age ≥75 years [95.4%], comorbidity [86.4%], functional status [77.3%], cancer family history [63.6%], U.S. Preventive Services Task Force guidelines [81.8%] and new research [77.3%] as factors influencing their recommendations. Fourteen women completed baseline surveys and received personalized decision aids (Mean age=79.1 years). Eleven completed the post-intervention survey. All were satisfied with the booklet length, 81.8% found the booklet easy to understand and 72.7% helpful in decision-making Perceived lifetime breast cancer risk decreased significantly from pre- to post-intervention (p = 0.02). Conclusions: Results suggest this decision aid, which incorporates key decisional factors from the clinician's perspective, is feasible and acceptable to patients. Innovation: A tailored decision aid booklet is innovative as it provides information on personalized risk and potential benefits and harms to older women considering screening.

Original languageEnglish (US)
Article number100132
JournalPEC Innovation
Volume2
DOIs
StatePublished - Dec 2023

Keywords

  • Benefits and harm
  • Breast cancer screening
  • Older adults
  • Person-centered decision-making

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health

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