Community health assessment and monitoring in the pharmacy (CHAMP): Protocol for a randomized stepped-wedge trial of lung cancer screening in community pharmacies.

BACKGROUND: Despite widespread insurance coverage and USPSTF recommendations, less than 20% of eligible individuals undergo annual lung cancer screening nationally. This low uptake suggests that innovative screening modalities and referral pathways are needed. We hypothesize that utilizing community pharmacies for screening and connecting patients to either traditional imaging or novel, blood-based modalities will improve uptake among eligible patients.

METHODS: We describe a multiphase study. First, during the initial phase, to assess the feasibility of community pharmacist-led lung cancer screening (LCS) and, subsequently, a randomized stepped-wedge trial expansion phase comparing pharmacist LCS intervention to usual care in ten community pharmacies. We plan to enroll 250 participants in the initial phase and 1000 participants in the expansion phase (approximately 500 participants in the usual care arm and 500 participants in the intervention arm). The primary endpoint is the proportion of LCS-eligible participants who receive a screening recommendation from a pharmacist and who both accept the recommendation and complete the screening.

DISCUSSION: This study will test the feasibility and efficacy of pharmacy-based LCS programs. By investigating an alternative LCS referral location and modality, our novel intervention seeks to supplement traditional primary care-based interventions to increase overall LCS rates. We hypothesize that this strategy can increase LCS rates from 20% to 40% of eligible participants.