Role of patient-provider communication on older adults' preferences for continuing colorectal cancer testing and visit satisfaction

Objective: To identify possible predictors of older adults' preferences for stopping or continuing colorectal cancer (CRC) testing and satisfaction with medical visits. Methods: Cross-sectional, secondary analysis of patient data. The parent study was a two-arm, multi-site clustered randomized trial, assigning primary care physicians to receive shared decision making training plus a reminder, or reminders alone for patients who were due for CRC testing. For the current analysis, patient data were pooled and analyzed without regard to study arm. Patients were aged 76-85 years. Results: In total, 375 patients reported their preference: 74 % preferred continued testing while 26 % preferred no further testing. In multivariable models, patients were more likely to prefer CRC testing if they had more maximizing preferences for health care, higher anticipated regret at missing a diagnosis, and lower anticipated regret about colonoscopy complications. Patients were more likely to report being extremely satisfied with the visit with longer duration spent discussing testing options. Conclusion: Anticipated decision regret and medical maximizing were associated with preferences for CRC testing. Time spent discussing CRC testing was associated with visit satisfaction. Practice Implications: To support informed decision making, older adults should be given thorough information about CRC testing, treatments, and post-treatment follow up.