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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| Format: | Article |
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Public Library of Science
2016
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| Online Access: | https://eprints.nottingham.ac.uk/40479/ |
| _version_ | 1848796067544432640 |
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| author | Wagland, Richard Brindle, Lucy Ewings, Sean James, Elizabeth Moore, Mike Rivas, Carol Esqueda, Ana Ibanez Corner, Jessica |
| author_facet | Wagland, Richard Brindle, Lucy Ewings, Sean James, Elizabeth Moore, Mike Rivas, Carol Esqueda, Ana Ibanez Corner, Jessica |
| author_sort | Wagland, Richard |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| 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. |
| first_indexed | 2025-11-14T19:42:05Z |
| format | Article |
| id | nottingham-40479 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:42:05Z |
| publishDate | 2016 |
| publisher | Public Library of Science |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-404792020-05-04T18:22:29Z https://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 Wagland, Richard, Brindle, Lucy, Ewings, Sean, James, Elizabeth, Moore, Mike, Rivas, Carol, 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 |
| 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 |
| title | 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_short | 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 |
| url | https://eprints.nottingham.ac.uk/40479/ https://eprints.nottingham.ac.uk/40479/ https://eprints.nottingham.ac.uk/40479/ |