Primary Care Providers and a System Problem: A Qualitative Study of Clinicians Caring for Patients With Incidental Pulmonary Nodules

Chest
Sara E GoldenChristopher G Slatore

Abstract

As lung cancer screening with low-dose CT scanning is implemented, an increasing number of people will be diagnosed with pulmonary nodules. Primary care clinicians care for the vast majority of these patients, but their experiences with communication and managing distress in this population are not well understood. We conducted qualitative interviews of 15 primary care providers (PCPs) at two academic medical centers who care for patients with pulmonary nodules. We used qualitative description analysis, focusing on clinicians' information exchange and other communication behaviors. Most PCPs believed they had inadequate information to counsel patients regarding lung nodules, although this information is desired. PCPs were concerned patients could "fall through the cracks" but did not have access to a reliable system to ensure follow-up adherence. They were limited by time, knowledge, and resources in providing the preferred level of care. Most PCPs did not discuss the specific risk a nodule was lung cancer, in part because they did not have ready access to this information. PCPs believed most patients did not have substantial distress as a result of nodule detection. Most PCPs did not include patients when making decisions abou...Continue Reading

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Citations

Mar 11, 2016·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Marc R FreimanRenda Soylemez Wiener
Mar 10, 2016·The Journal of Head Trauma Rehabilitation·Ellyn E MatthewsLisa A Brenner
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Mar 10, 2017·Annals of the American Thoracic Society·Jonathan M IaccarinoRenda Soylemez Wiener
Jul 13, 2019·Annals of the American Thoracic Society·Matthew TripletteDavid H Au
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Jun 5, 2020·Annals of the American Thoracic Society·Anne C MelzerChristopher G Slatore
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