RT Journal Article
SR Electronic
T1 ‘ThinkCancer!’: randomised feasibility trial of a novel practice-based early cancer diagnosis intervention
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP BJGPO.2023.0220
DO 10.3399/BJGPO.2023.0220
VO 8
IS 3
A1 Disbeschl, Stefanie LJ
A1 Hendry, Annie K
A1 Surgey, Alun
A1 Walker, Daniel
A1 Goulden, Nia
A1 Anthony, Bethany F
A1 Neal, Richard
A1 Williams, Nefyn H
A1 Hoare, Zoë Susannah Jane
A1 Hiscock, Julia
A1 Edwards, Rhiannon Tudor (RT)
A1 Lewis, Ruth
A1 Wilkinson, Clare
YR 2024
UL http://bjgpopen.org/content/8/3/BJGPO.2023.0220.abstract
AB Background 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.Aim To test the feasibility and acceptability of a novel, complex behavioural intervention, ‘ThinkCancer!’, for assessment in a subsequent Phase III trial.Design & setting Pragmatic, superiority pilot randomised controlled trial (RCT) with an embedded process evaluation and feasibility economic analysis in Welsh general practices.Method 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.Results Trial recruitment and workshop deliveries took place between March 2020 and 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.Conclusion ‘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.