Lucy B Spalluto1, Jennifer A Lewis2, Sageline LaBaze3, Kim L Sandler4, Alexis B Paulson4, Carol Callaway-Lane5, Eric L Grogan6, Pierre P Massion7, Christianne L Roumie8. 1. Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt Ingram Cancer Center, Nashville, Tennessee. Electronic address: lucy.b.spalluto@vumc.org. 2. Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee; Vanderbilt Ingram Cancer Center, Nashville, Tennessee; Department of Internal Medicine/Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee. 3. Loyola University of Chicago Stritch School of Medicine, Maywood, Illinois. 4. Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee. 5. Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee. 6. Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee; Veterans Health Administration-Tennessee Valley Healthcare System, Surgical Service, Nashville, Tennessee. 7. Vanderbilt Ingram Cancer Center, Nashville, Tennessee; Department of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Veterans Health Administration-Tennessee Valley Healthcare System, Medical Service, Nashville, Tennessee. 8. Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee; Department of Internal Medicine/Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee.
Abstract
BACKGROUND: Detection of early-stage lung cancer improves during subsequent rounds of screening with low-dose CT and potentially leads to saving lives with curative treatment. Therefore, adherence to annual lung screening is important. We hypothesized that adherence to annual screening would increase after hiring of a dedicated program coordinator. METHODS: We performed a mixed-methods study in a retrospective cohort of patients who underwent lung screening at our academic institution between January 1, 2014, and March 31, 2018. Patients with baseline lung screening examinations performed between January 1, 2014, and September 30, 2016, with Lung CT Screening Reporting & Data System 1 or 2 scores and a 12-month follow-up recommendation were included. We tracked patient adherence to annual follow-up lung screening over time (before and after hiring of a program coordinator) and conducted a cross-sectional survey of patients nonadherent to annual follow-up to elicit quantitative and qualitative feedback. RESULTS: Of the 319 patients who completed baseline lung screening with normal results, 189 (59%) were adherent to annual follow-up recommendations and 130 (41%) were nonadherent. Patient adherence varied over time: 21.7% adherence (10 of 46) before hiring a program coordinator and 65.6% adherence (179 of 273) after the program coordinator's hire date. Patients reported the following reasons for nonadherence to annual lung screening: lack of transportation, financial cost, lack of communication by physicians, and lack of current symptoms. CONCLUSIONS: Adherence to annual lung screening after normal baseline studies increased significantly over time. Hiring a full-time program coordinator was likely associated with this increased in adherence. Published by Elsevier Inc.
BACKGROUND: Detection of early-stage lung cancer improves during subsequent rounds of screening with low-dose CT and potentially leads to saving lives with curative treatment. Therefore, adherence to annual lung screening is important. We hypothesized that adherence to annual screening would increase after hiring of a dedicated program coordinator. METHODS: We performed a mixed-methods study in a retrospective cohort of patients who underwent lung screening at our academic institution between January 1, 2014, and March 31, 2018. Patients with baseline lung screening examinations performed between January 1, 2014, and September 30, 2016, with Lung CT Screening Reporting & Data System 1 or 2 scores and a 12-month follow-up recommendation were included. We tracked patient adherence to annual follow-up lung screening over time (before and after hiring of a program coordinator) and conducted a cross-sectional survey of patients nonadherent to annual follow-up to elicit quantitative and qualitative feedback. RESULTS: Of the 319 patients who completed baseline lung screening with normal results, 189 (59%) were adherent to annual follow-up recommendations and 130 (41%) were nonadherent. Patient adherence varied over time: 21.7% adherence (10 of 46) before hiring a program coordinator and 65.6% adherence (179 of 273) after the program coordinator's hire date. Patients reported the following reasons for nonadherence to annual lung screening: lack of transportation, financial cost, lack of communication by physicians, and lack of current symptoms. CONCLUSIONS: Adherence to annual lung screening after normal baseline studies increased significantly over time. Hiring a full-time program coordinator was likely associated with this increased in adherence. Published by Elsevier Inc.
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