Reducing the time before consulting with symptoms of lung cancer

randomised controlled trial in primary care

Sarah Smith, Shona Fielding, Peter Murchie, Marie Johnston, Sally Wyke, Rachael Powell, Graham Stuart Devereux, Marianne Nicolson, Una Macleod, Phil Wilson, Lewis Ritchie, Amanda J Lee, Neil C Campbell

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22 Citations (Scopus)

Abstract

Background
Most individuals with lung cancer have symptoms for several months before presenting to their GP. Earlier consulting may improve survival.
Aim
To evaluate whether a theory-based primary care intervention increased timely consulting of individuals with symptoms of lung cancer.
Design and setting
Open randomised controlled trial comparing intervention with usual care in two general practices in north-east Scotland.
Method
Smokers and ex-smokers aged =55 years were randomised to receive a behavioural intervention or usual care. The intervention comprised a single nurse consultation at participants' general practice and a self-help manual. The main outcomes were consultations within target times for individuals with new chest symptoms (=3 days haemoptysis, =3 weeks other symptoms) in the year after the intervention commenced, and intentions about consulting with chest symptoms at 1 and 6 months.
Results
Two hundred and twelve participants were randomised and 206 completed the trial. The consultation rate for new chest symptoms in the intervention group was 1.19 (95% confidence interval [CI] = 0.92 to 1.53; P = 0.18) times higher than in the usual-care group and the proportion of consultations within the target time was 1.11 (95% CI = 0.41 to 3.03; P = 0.83) times higher. One month after the intervention commenced, the intervention group reported intending to consult with chest symptoms 31 days (95% CI = 7 to 54; P = 0.012) earlier than the usual care group, and at 6 months this was 25 days (95% CI = 1.5 to 48; P = 0.037) earlier.
Conclusion
Behavioural intervention in primary care shortened the time individuals at high risk of lung disease intended to take before consulting with new chest symptoms (the secondary outcome of the study), but increases in consultation rates and the proportions of consultations within target times were not statistically significant.
Original languageEnglish
Pages (from-to)e47-e45
Number of pages8
JournalThe British Journal of General Practice
Volume63
Issue number606
DOIs
Publication statusPublished - Jan 2013

Fingerprint

Lung Neoplasms
Primary Health Care
Referral and Consultation
Randomized Controlled Trials
Thorax
Confidence Intervals
General Practice
Hemoptysis
Scotland
Lung Diseases
Nurses
Outcome Assessment (Health Care)

Keywords

  • early detection of cancer
  • general practice
  • illness behaviour
  • lung neoplasms
  • randomised controlled trial

Cite this

@article{c203a8c5e26c451485867683e9624deb,
title = "Reducing the time before consulting with symptoms of lung cancer: randomised controlled trial in primary care",
abstract = "BackgroundMost individuals with lung cancer have symptoms for several months before presenting to their GP. Earlier consulting may improve survival.AimTo evaluate whether a theory-based primary care intervention increased timely consulting of individuals with symptoms of lung cancer.Design and settingOpen randomised controlled trial comparing intervention with usual care in two general practices in north-east Scotland.MethodSmokers and ex-smokers aged =55 years were randomised to receive a behavioural intervention or usual care. The intervention comprised a single nurse consultation at participants' general practice and a self-help manual. The main outcomes were consultations within target times for individuals with new chest symptoms (=3 days haemoptysis, =3 weeks other symptoms) in the year after the intervention commenced, and intentions about consulting with chest symptoms at 1 and 6 months.ResultsTwo hundred and twelve participants were randomised and 206 completed the trial. The consultation rate for new chest symptoms in the intervention group was 1.19 (95{\%} confidence interval [CI] = 0.92 to 1.53; P = 0.18) times higher than in the usual-care group and the proportion of consultations within the target time was 1.11 (95{\%} CI = 0.41 to 3.03; P = 0.83) times higher. One month after the intervention commenced, the intervention group reported intending to consult with chest symptoms 31 days (95{\%} CI = 7 to 54; P = 0.012) earlier than the usual care group, and at 6 months this was 25 days (95{\%} CI = 1.5 to 48; P = 0.037) earlier.ConclusionBehavioural intervention in primary care shortened the time individuals at high risk of lung disease intended to take before consulting with new chest symptoms (the secondary outcome of the study), but increases in consultation rates and the proportions of consultations within target times were not statistically significant.",
keywords = "early detection of cancer, general practice, illness behaviour, lung neoplasms, randomised controlled trial",
author = "Sarah Smith and Shona Fielding and Peter Murchie and Marie Johnston and Sally Wyke and Rachael Powell and Devereux, {Graham Stuart} and Marianne Nicolson and Una Macleod and Phil Wilson and Lewis Ritchie and Lee, {Amanda J} and Campbell, {Neil C}",
year = "2013",
month = "1",
doi = "10.3399/bjgp13X660779",
language = "English",
volume = "63",
pages = "e47--e45",
journal = "The British Journal of General Practice",
issn = "0960-1643",
publisher = "Royal College of General Practitioners",
number = "606",

}

TY - JOUR

T1 - Reducing the time before consulting with symptoms of lung cancer

T2 - randomised controlled trial in primary care

AU - Smith, Sarah

AU - Fielding, Shona

AU - Murchie, Peter

AU - Johnston, Marie

AU - Wyke, Sally

AU - Powell, Rachael

AU - Devereux, Graham Stuart

AU - Nicolson, Marianne

AU - Macleod, Una

AU - Wilson, Phil

AU - Ritchie, Lewis

AU - Lee, Amanda J

AU - Campbell, Neil C

PY - 2013/1

Y1 - 2013/1

N2 - BackgroundMost individuals with lung cancer have symptoms for several months before presenting to their GP. Earlier consulting may improve survival.AimTo evaluate whether a theory-based primary care intervention increased timely consulting of individuals with symptoms of lung cancer.Design and settingOpen randomised controlled trial comparing intervention with usual care in two general practices in north-east Scotland.MethodSmokers and ex-smokers aged =55 years were randomised to receive a behavioural intervention or usual care. The intervention comprised a single nurse consultation at participants' general practice and a self-help manual. The main outcomes were consultations within target times for individuals with new chest symptoms (=3 days haemoptysis, =3 weeks other symptoms) in the year after the intervention commenced, and intentions about consulting with chest symptoms at 1 and 6 months.ResultsTwo hundred and twelve participants were randomised and 206 completed the trial. The consultation rate for new chest symptoms in the intervention group was 1.19 (95% confidence interval [CI] = 0.92 to 1.53; P = 0.18) times higher than in the usual-care group and the proportion of consultations within the target time was 1.11 (95% CI = 0.41 to 3.03; P = 0.83) times higher. One month after the intervention commenced, the intervention group reported intending to consult with chest symptoms 31 days (95% CI = 7 to 54; P = 0.012) earlier than the usual care group, and at 6 months this was 25 days (95% CI = 1.5 to 48; P = 0.037) earlier.ConclusionBehavioural intervention in primary care shortened the time individuals at high risk of lung disease intended to take before consulting with new chest symptoms (the secondary outcome of the study), but increases in consultation rates and the proportions of consultations within target times were not statistically significant.

AB - BackgroundMost individuals with lung cancer have symptoms for several months before presenting to their GP. Earlier consulting may improve survival.AimTo evaluate whether a theory-based primary care intervention increased timely consulting of individuals with symptoms of lung cancer.Design and settingOpen randomised controlled trial comparing intervention with usual care in two general practices in north-east Scotland.MethodSmokers and ex-smokers aged =55 years were randomised to receive a behavioural intervention or usual care. The intervention comprised a single nurse consultation at participants' general practice and a self-help manual. The main outcomes were consultations within target times for individuals with new chest symptoms (=3 days haemoptysis, =3 weeks other symptoms) in the year after the intervention commenced, and intentions about consulting with chest symptoms at 1 and 6 months.ResultsTwo hundred and twelve participants were randomised and 206 completed the trial. The consultation rate for new chest symptoms in the intervention group was 1.19 (95% confidence interval [CI] = 0.92 to 1.53; P = 0.18) times higher than in the usual-care group and the proportion of consultations within the target time was 1.11 (95% CI = 0.41 to 3.03; P = 0.83) times higher. One month after the intervention commenced, the intervention group reported intending to consult with chest symptoms 31 days (95% CI = 7 to 54; P = 0.012) earlier than the usual care group, and at 6 months this was 25 days (95% CI = 1.5 to 48; P = 0.037) earlier.ConclusionBehavioural intervention in primary care shortened the time individuals at high risk of lung disease intended to take before consulting with new chest symptoms (the secondary outcome of the study), but increases in consultation rates and the proportions of consultations within target times were not statistically significant.

KW - early detection of cancer

KW - general practice

KW - illness behaviour

KW - lung neoplasms

KW - randomised controlled trial

U2 - 10.3399/bjgp13X660779

DO - 10.3399/bjgp13X660779

M3 - Article

VL - 63

SP - e47-e45

JO - The British Journal of General Practice

JF - The British Journal of General Practice

SN - 0960-1643

IS - 606

ER -