Lung cancer diagnosed following an emergency admission: mixed methods study of the management, outcomes and needs and experiences of patients and carers
Background In the UK, although 40% of patients with lung cancer are diagnosed following an emergency admission (EA), data is limited on their needs and experiences as they progress through diagnostic and treatment pathways. Methods Prospective data collection using medical records, questionna...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Published: |
Elsevier
2016
|
| Subjects: | |
| Online Access: | https://eprints.nottingham.ac.uk/48255/ |
| _version_ | 1848797725436411904 |
|---|---|
| author | Wilcock, Andrew Crosby, Vincent Hussain, Asmah McKeever, Tricia M. Manderson, Cathann Farnan, Sarah Freer, Sarah Freemantle, Alison Littlewood, Fran Caswell, Glenys Seymour, Jane |
| author_facet | Wilcock, Andrew Crosby, Vincent Hussain, Asmah McKeever, Tricia M. Manderson, Cathann Farnan, Sarah Freer, Sarah Freemantle, Alison Littlewood, Fran Caswell, Glenys Seymour, Jane |
| author_sort | Wilcock, Andrew |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background
In the UK, although 40% of patients with lung cancer are diagnosed following an emergency admission (EA), data is limited on their needs and experiences as they progress through diagnostic and treatment pathways.
Methods
Prospective data collection using medical records, questionnaires and in-depth interviews. Multivariate logistic regression explored associations between diagnosis following EA and aspects of interest. Questionnaire responses with 95% confidence intervals were compared with local and national datasets. A grounded theory approach identified patient and carer themes.
Results
Of 401 patients, 154 (38%) were diagnosed following EA; 37 patients and six carers completed questionnaires and 13 patients and 10 carers were interviewed. Compared to those diagnosed electively, EA patients adjusted results found no difference in treatment recommendation, treatment intent or place of death. Time to diagnosis, review, or treatment was 7–14 days quicker but fewer EA patients had a lung cancer nurse present at diagnosis (37% vs. 62%). Palliative care needs were high (median [IQR] 21 [13–25] distressing or bothersome symptoms/issues) and various information and support needs unmet. Interviews highlighted in particular, perceived delays in obtaining investigations/specialist referral and factors influencing success or failure of the cough campaign.
Conclusions
Presentation as an EA does not appear to confer any inherent disadvantage regarding progress through lung cancer diagnostic and treatment pathways. However, given the frequent combination of advanced disease, poor performance status and prognosis, together with the high level of need and reported short-fall in care, we suggest that a specialist palliative care assessment is routinely offered. |
| first_indexed | 2025-11-14T20:08:26Z |
| format | Article |
| id | nottingham-48255 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:08:26Z |
| publishDate | 2016 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-482552020-05-04T20:03:02Z https://eprints.nottingham.ac.uk/48255/ Lung cancer diagnosed following an emergency admission: mixed methods study of the management, outcomes and needs and experiences of patients and carers Wilcock, Andrew Crosby, Vincent Hussain, Asmah McKeever, Tricia M. Manderson, Cathann Farnan, Sarah Freer, Sarah Freemantle, Alison Littlewood, Fran Caswell, Glenys Seymour, Jane Background In the UK, although 40% of patients with lung cancer are diagnosed following an emergency admission (EA), data is limited on their needs and experiences as they progress through diagnostic and treatment pathways. Methods Prospective data collection using medical records, questionnaires and in-depth interviews. Multivariate logistic regression explored associations between diagnosis following EA and aspects of interest. Questionnaire responses with 95% confidence intervals were compared with local and national datasets. A grounded theory approach identified patient and carer themes. Results Of 401 patients, 154 (38%) were diagnosed following EA; 37 patients and six carers completed questionnaires and 13 patients and 10 carers were interviewed. Compared to those diagnosed electively, EA patients adjusted results found no difference in treatment recommendation, treatment intent or place of death. Time to diagnosis, review, or treatment was 7–14 days quicker but fewer EA patients had a lung cancer nurse present at diagnosis (37% vs. 62%). Palliative care needs were high (median [IQR] 21 [13–25] distressing or bothersome symptoms/issues) and various information and support needs unmet. Interviews highlighted in particular, perceived delays in obtaining investigations/specialist referral and factors influencing success or failure of the cough campaign. Conclusions Presentation as an EA does not appear to confer any inherent disadvantage regarding progress through lung cancer diagnostic and treatment pathways. However, given the frequent combination of advanced disease, poor performance status and prognosis, together with the high level of need and reported short-fall in care, we suggest that a specialist palliative care assessment is routinely offered. Elsevier 2016-05 Article PeerReviewed Wilcock, Andrew, Crosby, Vincent, Hussain, Asmah, McKeever, Tricia M., Manderson, Cathann, Farnan, Sarah, Freer, Sarah, Freemantle, Alison, Littlewood, Fran, Caswell, Glenys and Seymour, Jane (2016) Lung cancer diagnosed following an emergency admission: mixed methods study of the management, outcomes and needs and experiences of patients and carers. Respiratory Medicine, 114 . pp. 38-45. ISSN 1532-3064 Lung cancer; Non-small cell lung cancer; Palliative care; Small cell lung cancer http://www.sciencedirect.com/science/article/pii/S0954611116300361 doi:10.1016/j.rmed.2016.03.006 doi:10.1016/j.rmed.2016.03.006 |
| spellingShingle | Lung cancer; Non-small cell lung cancer; Palliative care; Small cell lung cancer Wilcock, Andrew Crosby, Vincent Hussain, Asmah McKeever, Tricia M. Manderson, Cathann Farnan, Sarah Freer, Sarah Freemantle, Alison Littlewood, Fran Caswell, Glenys Seymour, Jane Lung cancer diagnosed following an emergency admission: mixed methods study of the management, outcomes and needs and experiences of patients and carers |
| title | Lung cancer diagnosed following an emergency admission: mixed methods study of the management, outcomes and needs and experiences of patients and carers |
| title_full | Lung cancer diagnosed following an emergency admission: mixed methods study of the management, outcomes and needs and experiences of patients and carers |
| title_fullStr | Lung cancer diagnosed following an emergency admission: mixed methods study of the management, outcomes and needs and experiences of patients and carers |
| title_full_unstemmed | Lung cancer diagnosed following an emergency admission: mixed methods study of the management, outcomes and needs and experiences of patients and carers |
| title_short | Lung cancer diagnosed following an emergency admission: mixed methods study of the management, outcomes and needs and experiences of patients and carers |
| title_sort | lung cancer diagnosed following an emergency admission: mixed methods study of the management, outcomes and needs and experiences of patients and carers |
| topic | Lung cancer; Non-small cell lung cancer; Palliative care; Small cell lung cancer |
| url | https://eprints.nottingham.ac.uk/48255/ https://eprints.nottingham.ac.uk/48255/ https://eprints.nottingham.ac.uk/48255/ |