Shared Decision Making In Early Lung Cancer Detection: Bridge Or Barrier? A Qualitative Interview Study
Author(s)
Lauren Michiels, PharmD1, Caro Verlies, MSc1, Jana Duchateau, PharmD1, Amelie Vangilbergen, PharmD1, Christophe Dooms, MD, PhD2, Guido Van Hal, PhD3, Isabelle Huys, PharmD, PhD1.
1Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium, 2Department of Respiratory Diseases and Chronic Diseases and Metabolism, UZ Leuven, Leuven, Belgium, 3Department of Family Medicine and Population Health, UAntwerpen, Antwerp, Belgium.
1Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium, 2Department of Respiratory Diseases and Chronic Diseases and Metabolism, UZ Leuven, Leuven, Belgium, 3Department of Family Medicine and Population Health, UAntwerpen, Antwerp, Belgium.
OBJECTIVES: Shared decision-making (SDM) is increasingly recognized as essential in healthcare, with proven effectiveness in improving patient outcomes. However, in preventive contexts such as early lung cancer detection, the critical question is whether both screening participants and healthcare providers (HCPs) are truly willing to engage in the process of SDM. While SDM can be effective, its application hinges on the motivation and readiness of stakeholders to actively participate in decisions, particularly in a preventive care setting where individuals may not yet perceive a direct health threat.
METHODS: This study employed semi-structured interviews with eligible lung cancer screening participants (n=13) and HCPs (n=22) across Belgium. Interviews explored perspectives on SDM in early lung cancer detection, including barriers and facilitators for implementing SDM in lung cancer screening clinical practice. The data were transcribed at verbatim and analyzed using the QUAGOL (Qualitative Analysis Guide of Leuven) method.
RESULTS: Many eligible lung cancer screening participants felt confident making decisions independently when adequately informed, while others expressed a stronger need for SDM. HCPs emphasized the importance of well-informed choices and a collaborative approach, particularly for individuals with lower health literacy. Key barriers to implementing SDM included time constraints for HCPs, stigma, and challenges related to low health literacy. The varying levels of understanding and patient preferences highlight the need for personalized communication strategies. User-friendly decision aids, such as videos and paper leaflets, were identified as essential tools to enhance the effectiveness and accessibility of SDM in this context.
CONCLUSIONS: Effective implementation of SDM in early lung cancer detection requires addressing key barriers, particularly for individuals with low health literacy. While many candidates prefer to make independent decisions once informed, some still require tailored support. The integration of personalized information resources, combined with HCPs who actively listen to participants’ decisional needs, can improve accessibility and promote equity in preventive care.
METHODS: This study employed semi-structured interviews with eligible lung cancer screening participants (n=13) and HCPs (n=22) across Belgium. Interviews explored perspectives on SDM in early lung cancer detection, including barriers and facilitators for implementing SDM in lung cancer screening clinical practice. The data were transcribed at verbatim and analyzed using the QUAGOL (Qualitative Analysis Guide of Leuven) method.
RESULTS: Many eligible lung cancer screening participants felt confident making decisions independently when adequately informed, while others expressed a stronger need for SDM. HCPs emphasized the importance of well-informed choices and a collaborative approach, particularly for individuals with lower health literacy. Key barriers to implementing SDM included time constraints for HCPs, stigma, and challenges related to low health literacy. The varying levels of understanding and patient preferences highlight the need for personalized communication strategies. User-friendly decision aids, such as videos and paper leaflets, were identified as essential tools to enhance the effectiveness and accessibility of SDM in this context.
CONCLUSIONS: Effective implementation of SDM in early lung cancer detection requires addressing key barriers, particularly for individuals with low health literacy. While many candidates prefer to make independent decisions once informed, some still require tailored support. The integration of personalized information resources, combined with HCPs who actively listen to participants’ decisional needs, can improve accessibility and promote equity in preventive care.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD102
Topic
Epidemiology & Public Health, Health Service Delivery & Process of Care, Patient-Centered Research
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology, Personalized & Precision Medicine, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)