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Maine Lung Cancer Coalition Lung Cancer Screening in Maine: Results of a Survey of Primary Care Clinicians Wednesday, November 13, 2019 Noon to 1pm Speaker: Dr. Neil Korsen

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Page 1: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Maine Lung Cancer Coalition

Lung Cancer Screening in Maine: Results

of a Survey of Primary Care Clinicians

Wednesday, November 13, 2019 – Noon to 1pm

Speaker: Dr. Neil Korsen

Page 2: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Webinar Logistics for Zoom

• Audio lines for non-presenters are currently muted

• Please use the chat box or Q&A function for questions or

comments throughout the presentation

• If you are requesting CME for this webinar and did not

sign into zoom through a direct link - or you are watching

as part of a group - please email [email protected]

during or immediately after the webinar so we can track your

participation

Page 3: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

CME • CME disclosure: The speaker today does not have any relevant financial

relationships with the manufacturers(s) of any commercial products(s) and/or provider of commercial services discussed in this CME activity.

• CME will be available for participants who have signed into the live webinar. If there are multiple people at one computer, please type their names and email addresses into the chat box for our attendance records.

• Once the webinar is ended by the host, you will get a pop-up on your screen that will immediately direct you to the survey. This survey will also be sent to you via email. Please complete the survey within 2 weeks.

• You will be able to immediately download your CME certificate on the last page of the survey. Please contact Danielle Ziller ([email protected]) if you have any questions, or problems downloading the document.

Page 4: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Learning Objectives:

• Explain the difference between the AAFP guideline on lung cancer

screening and other major organizations’ guidelines

• Describe the survey findings regarding guidelines endorsed and

current knowledge and practices

• Describe two of the biggest barriers the Maine primary care providers

identified in the lung cancer screening process for their patients

• List two ideas that might help primary care clinicians who want to offer

lung cancer screening to their patients who are eligible

Page 5: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Speaker: Dr Neil Korsen

Neil Korsen, MD, MS is the co-lead of the Maine Lung

Cancer Coalition. He is a physician scientist at the Center

for Outcomes Research and Evaluation at Maine Medical

Center. His research experience includes work on

depression in primary care, behavioral health integration,

shared decision making, and practice redesign.

Dr. Korsen spent almost 20 years as a family physician

and geriatrician in rural Maine. He returned to school and

graduated from the Master’s program at the Center for the

Evaluative Clinical Sciences at Dartmouth (now The

Dartmouth Institute) in 2002.

Page 6: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Lung Cancer Screening

Knowledge, Attitudes, and Practice

Preliminary results of a primary care provider survey

conducted by the Maine Lung Cancer Coalition

Page 7: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Funding

Page 8: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Partners

American Lung Association

American Cancer Society

Central Maine Medical Center

Chest Medicine Associates

Northern Light Eastern Maine Medical Center

Free ME from Lung Cancer

HealthReach Community Health Centers

Lung Cancer Alliance

Maine’s Impact Cancer Network

Maine Center for Disease Control & Prevention

Maine Medical Center

Maine Public Health Association

Maine Quality Counts

MaineGeneral Prevention Center

MaineHealth

MaineHealth Center for Tobacco Independence

Rinck Advertising

Southern Maine Medical Center

St. Mary’s Regional Medical Center

University of Southern Maine

Page 9: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Areas of focus

PreventionEarly

Detection

Stakeholder Engagement &

Education

Page 10: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

• Objective: assess primary care clinician

knowledge, attitudes, and practices regarding

lung cancer screening using low-dose CT

• State-wide

• Distributed to 1283 clinicians belonging to:

• Maine Academy of Family Physicians

• Maine chapter, American College of

Physicians

• Maine Primary Care Association

• Maine Family Medicine Residency programs

The Survey

Page 11: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

The sample

122 clinicians completed the survey:

• Family Medicine: 82

• Internal Medicine: 30

• NP/PA: 8

• Unknown specialty: 2

10% overall response rate

Page 12: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Participant

characteristics

N = 12259%

Female46 years

Mean age

14 yearsMean practice time

as a PCP

63%Work in mostly

outpatient setting

78%Mean percent of time allocated to

direct patient care

52Mean number of

patients seen weekly

Page 13: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Number of survey participants

by county

Respondents could endorse multiple counties

Page 14: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Attitudes • Benefits versus harms

• Perceived barriers to LDCT

• Confidence in skills

Page 15: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Attitudes about LDCT Screening

Page 16: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Attitudes about benefits and harms

Page 17: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Perceived barriers to LDCT uptake

Page 18: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Confidence in skills related to LDCT, by specialty

Page 19: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Current practice in lung cancer

screening

• Guideline adherence

• Scans ordered

• Shared Decision Making (SDM)

Page 20: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Which guidelines, if

any, do you follow for

lung cancer screening?

Respondents can endorse multiple

organizations’ guidelines

USPSTF: US Preventive Services Task Force

AAFP: American Academy of Family Physicians

ATS: American Thoracic Society

ACR: American College of Radiology

ACS: American Cancer Society

Other: 2 of 4 specify American College of Chest

Physicians

NCCN: National Comprehensive Cancer Network

Page 21: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Approximately how many patients did you refer for

LDCT screening in the last 3 months?

Page 22: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Current LDCT practices

Page 23: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Ideal model for LDCT screening

practice:

• How should LDCT screening services be

delivered to patients?

Page 24: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Who do you think should be responsible for the following services?

Page 25: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Conclusions • Maine PCPs report confidence in skills

related to lung cancer screening

• They support an active role for PCPs in the

lung cancer screening process

• Survey respondents generally recognized

the value of LDCT in detecting lung cancer

early, but were less convinced about its

value in decreasing lung cancer mortality.

Page 26: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Acknowledgements

• Paul Han, MD, MA, MPH– Principal Investigator

• Jaclyn Janis, BSN, RN– Data Analyst

• Susan Leeds, MOT– Research Coordinator

Thank You to Our Partners & Their

Membership:

• Maine Primary Care Association

• Maine Academy of Family Physicians

• American College of Physicians,

Maine Chapter

• The Maine Family Medicine

Residency Research Network

Page 27: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

Contact Information

• Dr Neil Korsen, Maine Lung Cancer Coalition

Phone: (207) 661-7616

Email: [email protected]

• Jessica Reed, Qualidigm

Phone: (207) 620-8526 x1003

Email: [email protected]

• Danielle Ziller, Qualidigm

Phone: 207.620.8526 x1016

Email: [email protected]

Page 28: Maine Lung Cancer Coalition Lung Cancer Screening in Maine: … · 2019-11-14 · CME • CME disclosure: The speaker today does not have any relevant financial relationships with

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