RT Journal Article
SR Electronic
T1 Cluster randomised feasibility trial to test the routine use of the Needs Assessment Tool: Cancer (NAT:-C) in primary care to reduce unmet patient and carer needs and determine the feasibility of a definitive trial
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP bjgp19X702857
DO 10.3399/bjgp19X702857
VO 69
IS suppl 1
A1 Joseph Clark
A1 Elvis Amoakwa
A1 John Blenkinsopp
A1 David Currow
A1 Amanda Farrin
A1 Robbie Foy
A1 Una Macleod
A1 David Meads
A1 Alexandra Wright-Hughes
A1 Miriam Johnson
YR 2019
UL http://bjgp.org/content/69/suppl_1/bjgp19X702857.abstract
AB Background People with cancer commonly have unidentified palliative care needs. The NAT-C is a validated tool to identify and triage unmet needs.Aim To assess the feasibility and acceptability of a primary care cRCT of the NAT-C: 1) recruiting four GP-practices and 40–60 patients, 2) uptake of NAT-C, 3) questionnaire completion 4) acceptability of measures.Method A non-blinded cRCT with process evaluation. Patients with active cancer were identified through cancer registries or opportunistically. Carers were nominated by patient-participant. Participants completed measures at baseline, 1, 3, and 6 months. Patients booked a 20-minute GP-assessment post-baseline. Patients, carers, and GP practice staff participated in interviews and focus groups.Results Five GP practices were approached, four recruited and trained in the use of the NAT-C. Practices were randomised (1:1) to provide a consultation with a known NAT-C trained clinician, or a clinician as usual. Forty-seven patients and 17 carers were recruited. Process evaluation informed refinement of study invitations. Recruitment rate showed a trial was feasible. Forty-three (94%) patients received a study appointment, 42/43 (95%) attended and 32/43 (76%) a NAT-guided consultation. The proposed primary outcome measure (Supportive Care Needs Survey) was completed by 43 (91%) at 1 month and the proportion with ≥1 moderate–severe unmet need fell from 72% (baseline) to 45%. Fifteen patient interviews and four focus groups with GP practices were conducted. Participants supported the definitive trial and found measures acceptable.Conclusion A definitive cRCT is feasible based on the recruitment rate, intervention uptake, and data collection.