The lung cancer death rate in Kentucky is 50 percent higher than the national average, accounting for more than a third of annual cancer deaths in the state.
In an effort to impact those dismal statistics, the Kentucky LEADS Primary Care Component has reached more than 1,200 primary care providers (PCPs) in Kentucky with continuing medical education on lung cancer. Nearly 1,000 of those have received the education in face-to-face “toolkit deliveries” by cancer control specialists of the Kentucky Cancer Program (KCP).
“This effort has given Kentucky providers a boost which we hope will improve lung cancer outcomes over time,” said Phil Bressoud, MD, governor of the Kentucky Chapter of the American College of Physicians. Bressoud, along with Melissa Zook, MD, past-president of the Kentucky Academy of Physicians, co-chaired a task force that planned the project. “Our goal was to find areas in which we could improve, then give doctors useful tools,” Bressoud said.
Toolkit deliveries launched in January of last year as the first of four educational offerings of the primary care component, which is an initiative of the Kentucky LEADS Collaborative, a joint venture of the University of Kentucky, University of Louisville, and Lung Cancer Alliance. Additional PCPs have participated in Kentucky LEADS group presentations at medical meetings or hospital grand rounds, or have taken the interactive online course, “Lung Cancer in Kentucky: Improving Patient Outcomes,” at www.LungCancerinKentucky.org.
All of the educational offerings cover lung cancer across the continuum of care, with an emphasis on the screening of eligible patients with low-dose CT scans. The US Preventive Services Task Force recommended lung cancer screening in late 2013, with Medicare coverage beginning in early 2015. The USPSTF recommendation was for adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Medicare covers screening for those eligible up to age 77.
Screening is important because only 16 percent of lung cancer is diagnosed at an early stage. However, the five-year survival rate for patients diagnosed with localized disease is 55 percent, compared to about four percent for those with distant disease, according to the National Cancer Institute. Medicare coverage for screening requires that providers referring patients to lung cancer screening use a shared decision making (SDM) approach to discuss the benefits and harms with patients. The Kentucky LEADS toolkit includes a shared decision making tool to assist providers in having those discussions. Other information provided supports improved tobacco cessation treatment, treatment advances and referral to cancer specialists, and resources for cancer survivorship.
The toolkits are also given to providers at Kentucky LEADS group presentations, and to those completing the online course. James Bosler, MD, who practices general internal medicine in the Louisville area, said the online course provided important information. “I felt good about doing it,” he said, adding that the information on survivorship was “eye opening.” Bosler said he keeps the toolkit on his desk because of its usefulness.
Toolkit deliveries can be arranged through November by contacting Kentucky Cancer Program at (502) 852-6318 or firstname.lastname@example.org. Also, up to two hours CME is available for the online course at www.LungCancerinKentucky.org. For a limited time, $100 Amazon gift cards are available for providing feedback online after participation in a toolkit delivery or the online course.
An on-demand webinar, “How to Save 712 Kentuckians This Year!” is also available for up to one hour CME/CE at www.cvent.com/d/t5q7b2. Kentucky primary care providers, cardiologists, pulmonologists, and lung cancer screening navigators are eligible for a $100 Amazon gift card for participation in the webinar and pre- and post-surveys.
Ruth Mattingly, MPA, is co-investigator, Kentucky LEADS, and assistant director for special initiatives, Kentucky Cancer Program, U of L