Patient Navigation for Lung Screening at MGH Community Health Centers

Massachusetts General Hospital1,200 enrolled

Overview

To develop and implement a patient navigator (PN) program for lung screening and smoking cessation in community health center primary care practices. This program will be evaluated in a randomized controlled trial of primary care patients who currently smoke.

The specific aims of this study are: Specific Aim 1: To develop a patient navigator (PN) program for lung screening for patients who are current smokers, aged 55-77 years, potentially eligible for lung screening and are receiving care at community health centers (CHCs) affiliated with MGH. Specific Aim 2: To evaluate the effectiveness of the new lung screening PN program in improving screening rates and increasing use of tobacco cessation services in a randomized controlled trial. Specific Aim 3: To demonstrate that equity is maintained in rates of lung screening and in follow up of abnormal chest CT results, comparing eligible smokers from CHCs with eligible smokers from other practices within the MGH primary care network.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

1,200

Conditions

Lung Cancer

Interventions

Patient NavigationOTHER

One to one patient navigation to obtain lung screening and follow-up of abnormal results, as well as smoking cessation guidance.

Usual CareOTHER

Usual care during the study period. After the study period, they will be offered 1:1 patient navigation to obtain lung screening and follow-up of abnormal results, as well as smoking cessation guidance.

Eligibility

Sex: ALLMin age: 55 YearsMax age: 77 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: 1. adult patients aged 55-77 years who are current cigarette smokers (according to an algorithm using electronic medical record data), and 2. receive care at one of the five Massachusetts General Hospital community health centers. Exclusion Criteria: 1. patients who have previously received a diagnosis of lung cancer, 2. have undergone a chest CT within 18 months before enrollment, 3. are subsequently identified as having died prior to the study intervention, 4. deemed by their primary care provider as not eligible for lung screening.

Locations (1)

Massachusetts General Hospital

Boston, Massachusetts, United States

Outcomes

Primary Outcomes

Chest CT Completion

Percentage of patients assigned to the intervention and control groups who had at least one chest CT (according to billing and EMR data) during the 1-year study period.

Time frame: Up to 1 year

Secondary Outcomes

Tobacco Treatment Use

Percentage of patients, comparing intervention and control groups, who during the 1-year study period had referral to Massachusetts Quitline, smoking cessation medication prescribed, or referral to in-person counseling.

Time frame: Up to 1 year

Data from ClinicalTrials.gov

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