Developing a complex intervention to reduce time to presentation with symptoms of lung cancer
Open accessAbstract
BACKGROUND: Lung cancer is the commonest cause of cancer in Scotland and is usually advanced at diagnosis. Median time between symptom onset and consultation is 14 weeks, so an intervention to prompt earlier presentation could support earlier diagnosis and enable curative treatment in more cases. AIM: To develop and optimise an intervention to reduce the time between onset and first consultation with symptoms that might indicate lung cancer. DESIGN AND SETTING: Iterative development of complex healthcare intervention according to the MRC Framework conducted in Northeast Scotland. METHOD: The study produced a complex intervention to promote early presentation of lung cancer symptoms. An expert multidisciplinary group developed the first draft of the intervention based on theory and existing evidence. This was refined following focus groups with health professionals and high-risk patients. RESULTS: First draft intervention components included: information communicated persuasively, demonstrations of early consultation and its benefits, behaviour change techniques, and involvement of spouses/partners. Focus groups identified patient engagement, achieving behavioural change, and conflict at the patient-general practice interface as challenges and measures were incorporated to tackle these. Final intervention delivery included a detailed self-help manual and extended consultation with a trained research nurse at which specific action plans were devised. CONCLUSION: The study has developed an intervention that appeals to patients and health professionals and has theoretical potential for benefit. Now it requires evaluation.
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Interventions were delivered in a variety of settings (e.g. inpatient, outpatient clinics and home-based settings) and targeted a wide range of conditions, such as mental health conditions, stroke, cancer and other chronic illnesses.
“Interventions were delivered in a variety of settings (e.g. inpatient, outpatient clinics and home-based settings) and targeted a wide range of conditions, such as mental health conditions [28, 30, 35, 40, 47], stroke [31, 36, 39], cancer [29, 32, 33, 37, 42] and other chronic illnesses [25, 34, 38].”
From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [32]
Fourteen included studies explored the acceptability and/or feasibility of the intervention to different stakeholders, including providers, recipients or policy makers and service commissioners.
“Fourteen studies explored the acceptability and/or feasibility of the intervention to different stakeholders, including providers, recipients or policy makers and service commissioners [27, 29–32, 34, 36, 37, 39, 40, 42, 43, 47, 48].”
From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [32]
17 of the 27 included studies used the MRC 2000 framework, the updated 2008 version, or a combination of the two.
“In particular, 17 of the 27 studies included in this review used the MRC 2000 framework, the updated 2008 version or a combination of the two [24–40].”
From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [32]
The majority of included studies (n = 16) subsequently refined the intervention to then test the optimised version within pilot studies or full-scale RCTs.
“The majority of studies (n = 16) subsequently refined the intervention to then test the optimised version of the intervention within pilot studies or full-scale RCTs [24–32, 34, 38–40, 43, 47, 48].”
From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [32]
The involvement of stakeholders was identified as a strength by several studies, as stakeholders play a key role in the implementation of interventions into practice.
“The involvement of stakeholders was identified as a strength by several studies, as stakeholders play a key role in the implementation of interventions into practice [30, 32, 33, 42, 43, 45].”
From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [32]
Several included studies employed well-established qualitative methods including interviews or focus groups with providers and recipients or relevant stakeholders, and observations and consensus processes including researchers, patients and clinical experts.
“Several studies employed well-established qualitative methods including interviews or focus groups with providers and recipients or relevant stakeholders [26, 30, 32, 34, 39, 47, 48] and observations and consensus processes including researchers, patients and clinical experts [31].”
From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [32]
Optimisation strategies applying qualitative methods tended to explore acceptability and feasibility issues.
“Optimisation strategies applying qualitative methods tended to explore acceptability and feasibility issues [26, 30, 32, 34, 39, 47, 48].”
From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [32]
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References 41 · Cited by 29
- Authors
- Smith, S. M., Murchie, P., Devereux, G., Johnston, M., Lee, A. J., Macleod, U., Nicolson, M. C., Powell, R., Ritchie, L. D., Wyke, S., & Campbell, N. C.
- Affiliations
- University of Aberdeen (GB)
- Aberdeen Royal Infirmary (GB)
- University of Hull (GB)
- Aston University (GB)
- University of Glasgow (GB)
- ORCID
- Venue
- British Journal of General Practice
- Published
- 2012-09
- Volume
- 62
- Issue
- 602
- Pages
- e605-e615
- ISSN
- 0960-1643 (ISSN-L)
- 1478-5242
- PMC
- PMC3426599
- OpenAlex
- W2152848901
- Cited by
- 29
- References
- 41
- Citations by year
- 2024: 3 · 2022: 1 · 2020: 1 · 2019: 5 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 1 · 2014: 4 · 2013: 2 · 2012: 2
- FWCI
- 2.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of General Practice (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Repository@Hull (Worktribe) (University of Hull) (submittedVersion, cc-by)
- Repository@Hull (Worktribe) (University of Hull) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- Cancer Research UK (C542/A8695)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- lung cancer, early presentation, time to consultation, early diagnosis, complex intervention development, behaviour change techniques, patient education, self-help books, research nurses, spouse involvement, intervention optimization
- MeSH terms
- Female, Health Promotion, Humans, Lung Neoplasms, Male, Patient Care Team, Physician-Patient Relations, Scotland, Health Behavior, Early Detection of Cancer, General Practice, Time-to-Treatment
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