Promoting help-seeking in response to symptoms amongst primary care patients at high risk of lung cancer: a mixed method study

Background: Lung cancer symptoms are vague and difficult to detect. Interventions are needed to promote early diagnosis, however health services are already pressurised. This study explored symptomology and help-seeking behaviours of primary care patients at ‘high-risk’ of lung cancer (≥50 years old...

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Main Authors:	Wagland, Richard, Brindle, Lucy, Ewings, Sean, James, Elizabeth, Moore, Mike, Rivas, Carol, Esqueda, Ana Ibanez, Corner, Jessica
Format:	Article
Language:	English
Published:	Public Library of Science 2016
Online Access:	http://eprints.nottingham.ac.uk/40479/ http://eprints.nottingham.ac.uk/40479/ http://eprints.nottingham.ac.uk/40479/ http://eprints.nottingham.ac.uk/40479/1/PLOS%20ONE_Promoting%20Help-seeking%20paper.pdf

id	nottingham-40479
recordtype	eprints
spelling	nottingham-404792018-07-02T09:10:54Z http://eprints.nottingham.ac.uk/40479/ Promoting help-seeking in response to symptoms amongst primary care patients at high risk of lung cancer: a mixed method study Wagland, Richard Brindle, Lucy Ewings, Sean James, Elizabeth Moore, Mike Rivas, Carol Esqueda, Ana Ibanez Corner, Jessica Background: Lung cancer symptoms are vague and difficult to detect. Interventions are needed to promote early diagnosis, however health services are already pressurised. This study explored symptomology and help-seeking behaviours of primary care patients at ‘high-risk’ of lung cancer (≥50 years old, recent smoking history), to inform targeted interventions. Methods: Mixed method study with patients at eight general practitioner (GP) practices across south England. Study incorporated: postal symptom questionnaire; clinical records review of participant consultation behaviour 12 months pre- and post-questionnaire; qualitative participant interviews (n = 38) with a purposive sample. Results: A small, clinically relevant group (n = 61/908, 6.7%) of primary care patients was identified who, despite reporting potential symptoms of lung cancer in questionnaires, had not consulted a GP ≥12 months. Of nine symptoms associated with lung cancer, 53.4% (629/1172) of total respondents reported ≥1, and 35% (411/1172) reported ≥2. Most participants (77.3%, n = 686/908) had comorbid conditions; 47.8%, (n = 414/908) associated with chest and respiratory symptoms. Participant consulting behaviour significantly increased in the 3-month period following questionnaire completion compared with the previous 3-month period (p = .002), indicating questionnaires impacted upon consulting behaviour. Symptomatic non-consulters were predominantly younger, employed, with higher multiple deprivation scores than their GP practice mean. Of symptomatic non-consulters, 30% (18/61) consulted ≤1 month post-questionnaire, with comorbidities subsequently diagnosed for five participants. Interviews (n = 39) indicated three overarching differences between the views of consulting and non-consulting participants: concern over wasting their own as well as GP time; high tolerance threshold for symptoms; a greater tendency to self-manage symptoms. Conclusions: This first study to examine symptoms and consulting behaviour amongst a primary care population at ‘high- risk’ of lung cancer, found symptomatic patients who rarely consult GPs, might respond to a targeted symptom elicitation intervention. Such GP-based interventions may promote early diagnosis of lung cancer or other comorbidities, without burdening already pressurised services. Public Library of Science 2016-11-04 Article PeerReviewed application/pdf en cc_by http://eprints.nottingham.ac.uk/40479/1/PLOS%20ONE_Promoting%20Help-seeking%20paper.pdf Wagland, Richard and Brindle, Lucy and Ewings, Sean and James, Elizabeth and Moore, Mike and Rivas, Carol and Esqueda, Ana Ibanez and Corner, Jessica (2016) Promoting help-seeking in response to symptoms amongst primary care patients at high risk of lung cancer: a mixed method study. PLoS ONE, 11 (11). e0165677/1-e0165677/20. ISSN 1932-6203 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0165677 doi:10.1371/journal.pone.0165677 doi:10.1371/journal.pone.0165677
repository_type	Digital Repository
institution_category	Local University
institution	University of Nottingham Malaysia Campus
building	Nottingham Research Data Repository
collection	Online Access
language	English
description	Background: Lung cancer symptoms are vague and difficult to detect. Interventions are needed to promote early diagnosis, however health services are already pressurised. This study explored symptomology and help-seeking behaviours of primary care patients at ‘high-risk’ of lung cancer (≥50 years old, recent smoking history), to inform targeted interventions. Methods: Mixed method study with patients at eight general practitioner (GP) practices across south England. Study incorporated: postal symptom questionnaire; clinical records review of participant consultation behaviour 12 months pre- and post-questionnaire; qualitative participant interviews (n = 38) with a purposive sample. Results: A small, clinically relevant group (n = 61/908, 6.7%) of primary care patients was identified who, despite reporting potential symptoms of lung cancer in questionnaires, had not consulted a GP ≥12 months. Of nine symptoms associated with lung cancer, 53.4% (629/1172) of total respondents reported ≥1, and 35% (411/1172) reported ≥2. Most participants (77.3%, n = 686/908) had comorbid conditions; 47.8%, (n = 414/908) associated with chest and respiratory symptoms. Participant consulting behaviour significantly increased in the 3-month period following questionnaire completion compared with the previous 3-month period (p = .002), indicating questionnaires impacted upon consulting behaviour. Symptomatic non-consulters were predominantly younger, employed, with higher multiple deprivation scores than their GP practice mean. Of symptomatic non-consulters, 30% (18/61) consulted ≤1 month post-questionnaire, with comorbidities subsequently diagnosed for five participants. Interviews (n = 39) indicated three overarching differences between the views of consulting and non-consulting participants: concern over wasting their own as well as GP time; high tolerance threshold for symptoms; a greater tendency to self-manage symptoms. Conclusions: This first study to examine symptoms and consulting behaviour amongst a primary care population at ‘high- risk’ of lung cancer, found symptomatic patients who rarely consult GPs, might respond to a targeted symptom elicitation intervention. Such GP-based interventions may promote early diagnosis of lung cancer or other comorbidities, without burdening already pressurised services.
format	Article
author	Wagland, Richard Brindle, Lucy Ewings, Sean James, Elizabeth Moore, Mike Rivas, Carol Esqueda, Ana Ibanez Corner, Jessica
spellingShingle	Wagland, Richard Brindle, Lucy Ewings, Sean James, Elizabeth Moore, Mike Rivas, Carol Esqueda, Ana Ibanez Corner, Jessica Promoting help-seeking in response to symptoms amongst primary care patients at high risk of lung cancer: a mixed method study
author_facet	Wagland, Richard Brindle, Lucy Ewings, Sean James, Elizabeth Moore, Mike Rivas, Carol Esqueda, Ana Ibanez Corner, Jessica
author_sort	Wagland, Richard
title	Promoting help-seeking in response to symptoms amongst primary care patients at high risk of lung cancer: a mixed method study
title_short	Promoting help-seeking in response to symptoms amongst primary care patients at high risk of lung cancer: a mixed method study
title_full	Promoting help-seeking in response to symptoms amongst primary care patients at high risk of lung cancer: a mixed method study
title_fullStr	Promoting help-seeking in response to symptoms amongst primary care patients at high risk of lung cancer: a mixed method study
title_full_unstemmed	Promoting help-seeking in response to symptoms amongst primary care patients at high risk of lung cancer: a mixed method study
title_sort	promoting help-seeking in response to symptoms amongst primary care patients at high risk of lung cancer: a mixed method study
publisher	Public Library of Science
publishDate	2016
url	http://eprints.nottingham.ac.uk/40479/ http://eprints.nottingham.ac.uk/40479/ http://eprints.nottingham.ac.uk/40479/ http://eprints.nottingham.ac.uk/40479/1/PLOS%20ONE_Promoting%20Help-seeking%20paper.pdf
first_indexed	2018-09-06T13:06:37Z
last_indexed	2018-09-06T13:06:37Z
_version_	1610863552424312832

Promoting help-seeking in response to symptoms amongst primary care patients at high risk of lung cancer: a mixed method study

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