'ThinkCancer!' - Randomised feasibility trial of a novel practice-based early cancer diagnosis intervention

UK cancer deaths remain high; primary care is key for earlier cancer diagnosis as half of avoidable delays occur here. Improvement is possible through lower referral thresholds, better guideline adherence, and better safety netting systems. Few interventions target whole practice teams. We developed...

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Bibliographic Details
Published in:	BJGP open Vol. 8; no. 3; p. BJGPO.2023.0220
Main Authors:	Disbeschl, Stefanie Lj, Hendry, Annie K, Surgey, Alun, Walker, Daniel, Goulden, Nia, Anthony, Bethany F, Neal, Richard, Williams, Nefyn H, Hoare, Zoë Susannah Jane, Hiscock, Julia, Edwards, Rhiannon Tudor Rt, Lewis, Ruth, Wilkinson, Clare
Format:	Journal Article
Language:	English
Published:	England Royal College of General Practitioners 01-10-2024
Subjects:	cancer diagnosis feasibility studies general practitioners practice-based primary healthcare randomized controlled trial think cancer Think Cancer practice-based Randomised
Online Access:	Get full text
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Summary:	UK cancer deaths remain high; primary care is key for earlier cancer diagnosis as half of avoidable delays occur here. Improvement is possible through lower referral thresholds, better guideline adherence, and better safety netting systems. Few interventions target whole practice teams. We developed a novel whole practice team intervention to address this. To test the feasibility and acceptability of a novel, complex behavioural intervention 'ThinkCancer!' for assessment in a subsequent Phase III trial. Pragmatic, superiority pilot RCT with an embedded process evaluation and feasibility economic analysis in Welsh general practices. Clinical outcome data were collected from practices (the unit of randomisation). Practice characteristics and cancer safety netting systems were assessed. Individual practice staff completed evaluation and feedback forms, and qualitative interviews. The intervention was adapted and refined. Trial recruitment and workshop deliveries took place between March 2020 to May 2021. Trial progression criteria for recruitment, intervention fidelity and routine data collection were met. Staff-level fidelity, retention and individual level data collection processes were reviewed and amended. Interviews highlighted positive participant views on all aspects of the intervention. All practices set out to liberalise referral thresholds appropriately, implement guidelines, and address safety netting plans in detail. 'ThinkCancer!' appears feasible and acceptable; the new iteration of the workshops was completed, and the Phase III trial has been funded to assess the effectiveness and cost effectiveness of this novel professional behaviour change intervention. Delivery at scale to multiple practices will likely improve fidelity and reach.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2398-3795 2398-3795
DOI:	10.3399/BJGPO.2023.0220