(1291) Implementation of a Systematic Approach to Identify Computed Tomography (CT) Scan Candidates in Current and Former Smokers in a Federally Qualified Health Center (FQHC)

Objectives: The primary objective of this study is to determine the percent of patients at a Federally Qualified Health Center (FQHC) that are due for low-dose computed tomography (LDCT) screening according to the United States Preventative Services Task Force (USPSTF) recommendation. Secondary objectives include: (1) of those eligible for the CT scan, determine the percent that have had an order for a CT scan placed, (2) determine the number of CT scans completed within one year of order, and (3) determine the number of patients that have ever completed a CT scan screening once criteria was met.

Cigarette smoking is the number one risk factor for lung cancer. In the United States, cigarette smoking is linked to about 80% to 90% of lung cancer deaths. Due to this increased risk, it is suggested that patients have a lung cancer screening performed. Research shows that early detection of lung cancer can improve 5-year survival rate up to 63%. The USPSTF recommends an annual CT screen for lung cancer for individuals 50-80 years old who have at least a 20 pack-year smoking history and currently smoke, or have quit within the past 15 years. The USPSTF recommends the scan annually, however it is underutilized for a majority of patients. A study in 2014, found that only 14.6% of current smokers and 12.7% of former smokers had received a CT scan. For those who had not had a CT scan, 78.5% of current smokers and 81.4% of former smokers indicated that they would complete the test if it was recommended by their practitioner. This study aims to review adherence to the USPSTF guidance for lung cancer screening in former and current smokers in a FQHC setting in order to gauge opportunity for a utilizing a team-based approach to improve access.

Methods: This study takes place at a multisite, interprofessional FQHC that offers tobacco cessation services under collaborative practice agreement between the clinical pharmacy team and primary care providers. A retrospective chart review will be conducted utilizing an electronic health record (EHR) report to identify patients who have completed a smoking cessation visit with the clinical pharmacy team and meet USPSTF recommendations for screening between January 1, 2021, and December 31, 2022. This report gathers patient demographics, primary language, the consulting prescriber name, type of provider (physician or nurse practitioner), practice location, date of completed tobacco cessation visit, the number of years of tobacco use, cigarette packs per day, calculated pack years, current smoking status, CT scan orders, and status of completion. Descriptive statistics will be used to improve the clinics’ screening practices and access to recommended lung cancer screenings.

Results: Data collection in progress.

Conclusions: Research in progress to be presented at APhA Annual 2024.