Pilot study of decision support tools on breast cancer chemoprevention for high-risk women and healthcare providers in the primary care setting

• DOI: 10.1186/s12911-018-0716-5
• Publication Date: 2018-12-17T09:00:45Z
• Authors: Rita Kukafka; Jiaqi Fang; Alejandro Vanegas; Thomas Silverman; Katherine D. Crew
• Keywords: Adult; Health Knowledge, Attitudes, Practice; Computer applications to medicine. Medical informatics; Clinical Decision-Making; Decision Making; R858-859.7; 610; Breast Neoplasms; Pilot Projects; Medical care--Decision making; Chemoprevention; Risk Assessment; Risk communication; Decision Support Techniques; 03 medical and health sciences; Breast cancer; 0302 clinical medicine; Decision conflict; Cancer--Chemoprevention; Humans; Primary care (Medicine); Aged; Primary Health Care; Middle Aged; Decision support; 3. Good health; Breast--Cancer; Decision aids; Female; Research Article

Background Breast cancer chemoprevention can reduce breast cancer incidence in high-risk women; however, chemoprevention is underutilized in the primary care setting. We conducted a pilot study of decision support tools among high-risk women and their primary care providers (PCPs). Methods The intervention included a decision aid (DA) for high-risk women, RealRisks, and a provider-centered tool, Breast Cancer Risk Navigation (BNAV). Patients completed validated surveys at baseline, after RealRisks and after their PCP clinical encounter or at 6-months. Referral for high-risk consultation and chemoprevention uptake were assessed via the electronic health record. The primary endpoint was accuracy of breast cancer risk perception at 6-months. Results Among 40 evaluable high-risk women, median age was 64.5 years and median 5-year breast cancer risk was 2.19%. After exposure to RealRisks, patients demonstrated an improvement in accurate breast cancer risk perceptions (p = 0.02), an increase in chemoprevention knowledge (p