Implementing decision support for breast cancer chemoprevention in primary care.

• DOI: 10.1200/jco.2017.35.15_suppl.e13038
• Publication Date: 2018-09-06T15:40:48Z
• Authors: Jersen Telfort; Meghna S. Trivedi; Hae Seung Yi; Hilary Colbeth; Alejandro Vanegas; Jennifer Vargas; Rossy Sandoval; Jeffrey Wood; Jill Dimond; Joseph Finkelstein; Rita Kukafka; Katherine D Crew
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

e13038 Background: Breast cancer risk assessment and chemoprevention with anti-estrogens among high-risk women are underutilized. We developed web-based decision support tools for women, RealRisks, their primary care providers (PCPs), BNAV, which integrated into clinic workflow. Methods: conducted a pilot study in 50 who were found to have 5-year of invasive breast ≥1.67% according the Gail model during screening mammography. RealRisks includes modules on chemoprevention, as well interactive games communicate preference elicitation chemoprevention. A tailored patient provider action plan is generated summarizing profile. Before after interacting participants completed validated questionnaires knowledge intention. Prior next visit, PCPs given access BNAV reference toolbox. High-risk referrals uptake assessed by medical chart review. Paired t-tests chi-square tests used analyze continuous categorical variables pre/post-intervention, respectively. Results: From Mar Aug 2016, enrolled 40 evaluable. Median age 64.5 years (range, 49-72); white/black/Hispanic (%): 37.5/25/37.5; 35% had adequate health literacy; median was 2.2% 1.7-3.9). we observed an increase (60% vs. 84%, p = .01) (5% 25%, < .01). After viewing 30% interested taking anti-estrogen 33% not interested, 37% unsure. Thus far, only 2 referred consultations no initiated Conclusions: Despite increased interest exposure additional barriers exist, including competing comorbidities time constraints clinical encounter. Targeting younger higher may uptake. Clinical trial information: NCT02954900.