Abstract

Lung cancer is the leading cause of cancer death in the UK. Primary treatment has curative intent only in about 10% of cases. There is currently little evidence that suggests what type of follow-up is most beneficial to patients, or cost effective, after initial treatment. Follow-up is important so appropriate second line treatment or supportive or palliative care can be introduced.  Innovative methods of follow-up have been developed in other types of cancer, these have been successful at delivering similar outcomes and patient satisfaction as traditional hospital based follow-up. 

Aims

This study has two aims

·         to develop a new intervention for the follow-up of lung cancer patients

·         to test this intervention for feasibility

A new intervention will be developed drawing on a review of current evidence and investigating service users and other stakeholders’ views. An exploratory trial will then determine its efficacy, responsiveness to patients’ needs and benefits to quality of life.

Methods

A systematic review of nurse led interventions for cancer patients will be undertaken to clarify what interventions have already been developed and evaluated. A review of current practice to determine the aim and method of standard follow-up will be conducted at the study sites. The MRC framework for the development and evaluation of randomised controlled trials for complex interventions to improve health will be used to guide the study and develop a robust intervention. An exploratory trial will determine if this new intervention is potentially beneficial. The outcome measures of this study will focus on quality of life, symptom control and patient satisfaction but will include survival and economic evaluation as secondary measures.

Medical and scientific opportunities

This study will provide a unique opportunity to investigate an under researched disease group. Current evidence from nurse led interventions with other cancers are likely to be limited for this disease group, as treatment is only likely to be curative in a small number of patients. This study, although challenging, will provide the opportunity to examine how symptom control, quality of life and patient satisfaction may be improved by using the expertise of specialist nurses. The proposed research will strengthen links between the School of Nursing, Midwifery and Social Work, the Medical School and clinical colleagues in cancer centres. This research will add another dimension to thematic research in cancer follow-up at the School.