Karen Sepucha, PhD and Leigh Simmons, MD Approved for $2 Million in Research Funding to Implement an Effective Shared Decision Making Approach to Enhance Colorectal Cancer Screening Conversations for Adults Aged 76-85.

Funds awarded by the Patient-Centered Outcomes Research Institute

Karen Sepucha, PhD and Leigh Simmons, MD from the Health Decision Sciences Center (HDSC) at Massachusetts General Hospital (MGH) have been approved for a $2 million funding award by the Patient-Centered Outcomes Research Institute (PCORI) to disseminate and implement interventions designed to enhance decisions about continuing or stopping colorectal cancer screening for adults aged 76-85. The original study, Promoting Informed Decisions about Colorectal Cancer Screening for Older Adults (PRIMED Study), found that shared decision making skills training plus reminders improved the quality of conversations about colorectal cancer testing decisions with primary care clinicians and their older patients. This project will implement those findings widely. Even the most impactful findings from clinical research studies can take years to make it into widespread clinical practice. Cutting that lag time and smoothing the path to uptake is the focus of this PCORI-funded project.

“We are thrilled to be able to pursue this implementation study that will take advantage of health information technology tools to ensure that primary care clinicians meaningfully involve patients in colorectal cancer screening decisions,” said Karen Sepucha, PhD, director of the Health Decision Sciences Center in the General Medicine Division at MGH.

There is tremendous variability in cancer risk, functional status, and life expectancy in older adults, and these factors influence patients’ preferences and decision making about continued colorectal cancer screening. Older patients who are at higher risk for complications of colonoscopy may consider switching to a less invasive stool test or may decide to stop altogether, depending on their goals and health priorities. Some older adults may have a long-life expectancy and a strong desire to reduce their colorectal cancer risk, and for them, continued screening may make sense.  Clinical guidelines recommend that physicians individualize these decisions for adults aged 76 to 85, indicating broad support of shared decision making in this setting.

The MGH team is working with five sites from across the country to implement the multifaceted shared decision making interventions. The study team includes a committed group of advisors with expertise in digital health, primary care leadership, quality improvement and cancer screening, as well as a group of patient partners, who have lived experience with colorectal cancer screening.    The findings will have wide reaching implications to help hospitals incorporate these strategies into existing primary care practices.

“This project is part of a portfolio of PCORI-funded projects that aim to improve the awareness, uptake and use of results from patient-centered comparative clinical effectiveness research,” said PCORI Executive Director Nakela L. Cook, M.D., MPH. “Through a highly competitive review process, awardees’ proposals were assessed for the importance of the findings being shared and implemented and the potential for the project to lead to changes in practice and improvements in health care and health outcomes.”

Drs. Sepucha and Simmons’ funding award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.

PCORI is an independent, nonprofit organization authorized by Congress with a mission to fund patient-centered comparative clinical effectiveness research that provides patients, their caregivers and clinicians with the evidence-based information they need to make better informed health and healthcare decisions.

For more information about PCORI’s funding to support implementation efforts, visit https://www.pcori.org/DisseminationAwards.

The Health Decision Sciences Center at MGH is committed to improving the quality of health care decisions. For more information about the HDSC, visit www.mghdecisionsciences.org.