Protocol for a feasibility study incorporating a randomised pilot trial with an embedded process evaluation and feasibility economic analysis of ThinkCancer!: a primary care intervention to expedite cancer diagnosis in Wales

Pilot and Feasibility Studies

Richard D. Neal¹  Bethany Fern Anthony²  Rhiannon Tudor Edwards²  Nefyn Williams³  Andrew Carson-Stevens⁴  Stefanie Disbeschl⁵  Annie Hendry⁵  Alun Surgey⁵  Ruth Lewis⁵  Jessica L. Roberts⁵  Julia Hiscock⁵  Clare Wilkinson⁵  Rebecca-Jane Law⁵  Zoe Hoare⁶  Nia Goulden⁶ 

[1] Academic Unit of Primary Care, Leeds Institute of Health Sciences, University of Leeds;Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University;Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool;Division of Population Medicine, School of Medicine, Cardiff University;North Wales Centre for Primary Care Research (NWCPCR), Bangor University;North Wales Organisation for Randomised Trials in Health (NWORTH), Bangor University;

关键词: Early cancer diagnosis;    Feasibility;    Primary care;    General practitioners;    Safety netting;    Health economics;   

DOI  :  10.1186/s40814-021-00834-y

来源: DOAJ

【 摘 要 】

Abstract Background Compared to the rest of Europe, the UK has relatively poor cancer outcomes, with late diagnosis and a slow referral process being major contributors. General practitioners (GPs) are often faced with patients presenting with a multitude of non-specific symptoms that could be cancer. Safety netting can be used to manage diagnostic uncertainty by ensuring patients with vague symptoms are appropriately monitored, which is now even more crucial due to the ongoing COVID-19 pandemic and its major impact on cancer referrals. The ThinkCancer! workshop is an educational behaviour change intervention aimed at the whole general practice team, designed to improve primary care approaches to ensure timely diagnosis of cancer. The workshop will consist of teaching and awareness sessions, the appointment of a Safety Netting Champion and the development of a bespoke Safety Netting Plan and has been adapted so it can be delivered remotely. This study aims to assess the feasibility of the ThinkCancer! intervention for a future definitive randomised controlled trial. Methods The ThinkCancer! study is a randomised, multisite feasibility trial, with an embedded process evaluation and feasibility economic analysis. Twenty-three to 30 general practices will be recruited across Wales, randomised in a ratio of 2:1 of intervention versus control who will follow usual care. The workshop will be delivered by a GP educator and will be adapted iteratively throughout the trial period. Baseline practice characteristics will be collected via questionnaire. We will also collect primary care intervals (PCI), 2-week wait (2WW) referral rates, conversion rates and detection rates at baseline and 6 months post-randomisation. Participant feedback, researcher reflections and economic costings will be collected following each workshop. A process evaluation will assess implementation using an adapted Normalisation Measure Development (NoMAD) questionnaire and qualitative interviews. An economic feasibility analysis will inform a future economic evaluation. Discussion This study will allow us to test and further develop a novel evidenced-based complex intervention aimed at general practice teams to expedite the diagnosis of cancer in primary care. The results from this study will inform the future design of a full-scale definitive phase III trial. Trial registration ClinicalTrials.gov NCT04823559 .

【 授权许可】

Unknown