B105
Reducing time to presentation with symptoms of lung cancer: phase II complex intervention study
Sarah Smith, Neil Campbell, Peter Murchie
University of Aberdeen, UK
Background
Lung cancer survival rates in the UK are poor compared with other developed countries and a significant factor is later stage disease at diagnosis. The total time between onset of symptoms and diagnosis is frequently long, with the longest component usually before presentation.1 There are calls for strategies to reduce time to presentation, but no current evidence based means to achieve this. This study aims to investigate whether a theoretically-based educational intervention in primary care has potential to reduce time between onset of, and presentation with, symptoms suggestive of lung cancer.
Method
A complex intervention, targeting people at high risk of lung cancer and other lung disease, delivered in primary care. The intervention comprises of a research nurse consultation, and a self-management manual with personalised action plans. A phase II randomised controlled trial of 200 high risk participants (>55 years smokers and ex-smokers) from one urban and one rural practice in NE Scotland, will evaluate how the intervention affects consulting behaviour. Data will be collected from general practice case notes and structured questionnaires. A parallel qualitative study will explore the perspective of participants and health professionals to the intervention
Results
Recruitment to the trial has been completed, and intervention implementation is near conclusion. Data collection is ongoing. Early qualitative analysis from participant interviews shows the intervention positively received. The effect on consulting behaviour has yet to be evaluated.
Conclusion
Our findings will identify barriers to implementing the intervention and will suggest improvements. Our findings on recruitment, retention, and effect sizes could inform a definitive phase III randomised trial. If the intervention is effective it could result in earlier diagnosis of lung cancer and improve survival rates. If not effective, our findings will identify why, informing the iterative process of ongoing intervention development in this field.
References
[1] Macdonald S et al. Factors influencing patient and primary care delay in the diagnosis of cancer: a database of existing research and its implications for future practice. Final Report to the Department of Health (Ref 1217522). Glasgow: University of Glasgow, 2004.
