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Le promoteur: Department of Health
Department of Health MAJ Il y a 4 ans

Writing to patients to encourage them to report symptoms to their GP Background and study aims Diagnosis of cancer during late stages of the disease and the resultant poor survival is more common in those from disadvantaged backgrounds, among certain ethnic groups, among those suffering from more other health conditions and among those first presenting with cancer to emergency medical services. Other possible factors which may make patients more likely to first present to healthcare services during the late stages of cancer include infrequent contact with their general practice, lack of engagement in cancer screening, and possibly a tendency to use acute or emergency services in preference to primary care. Previous initiatives (such as The Be Clear on Cancer Campaigns) took the form of television and radio advertisements and posters which were aimed at the public in general. For both financial and public health reasons, it is advantageous to target these programs towards those least likely to seek help for symptoms and those most at risk of advanced stage disease at diagnosis. If successful this might then lead to cancer diagnoses being made an earlier point when the cancer is at a more treatable stage. Targeted programs also provide the opportunity to tailor the programs so that it is most likely to appeal to the specific audience. The aim of this study is to find out whether a targeted program aimed at those at risk of presenting with late-stage cancer results in increased engagement with primary care. Who can participate? General Practices from three geographical clusters (London, Manchester and The North of England) have been invited to participate. From their patients they will select approximately seventy who are eligible. These are adults aged between 50 and 84 who have not seen their GP for a year and come from a disadvantaged background; missed their last cancer screening; have a history of using out of hours or emergency services rather than seeing a GP; missed their last appointment for long-term disease management; have low social support; or have ever smoked. What does the study involve? Selected patients are randomly allocated to one of two groups. Those in the first group receive normal care only. Those in the second group receive normal care and also receive a cancer awareness leaflet and letter by post. At the end of six months, patients' usual care teams record the number of and type of consultations attended by all selected patients during that six month period to compare whether there are any significant differences between the amount of patients going to see their GP in the two study groups. What are the possible benefits and risks of participating? Of those patients that are randomly assigned to receive the intervention some may already have symptomatic cancer but have not reported it to a health professional. As a result of the intervention these patients may arrange a consultation with their general practitioner. This in turn could lead to an earlier diagnosis of cancer and result in improved health outcome and a better chance of survival. Some other patients that are randomly assigned to receive the intervention may have symptoms that appear cancerous but are in fact benign or represent a different disease. This group may benefit from being reassured by their doctor that their symptoms are not a cause for concern or alternatively from appropriate treatment. Though both leaflet and letter are designed to re-engage members of hard to reach populations with primary care it is possible that it could generate anxiety in patients. In order to reduce these risks both the leaflet and letter have been written deliberately in a way that aims to minimise anxiety. Where is the study run from? Wolfson Institute of Preventive Medicine (UK) When is the study starting and how long is it expected to run for? June 2016 to December 2017 Who is funding the study? Department of Health (UK) Who is the main contact? Dr Jean-Pierre Laake

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