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K. White



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    P1.22 - Poster Session 1 - Epidemiology, Etiology (ID 166)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Prevention & Epidemiology
    • Presentations: 1
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      P1.22-008 - Identifying evidence-practice gaps in lung cancer and priority setting with clinicians in NSW, Australia. (ID 2518)

      09:30 - 16:30  |  Author(s): K. White

      • Abstract

      Background
      Implementation Science has emerged over the past 20 years to highlight a fundamental problem in health care: that knowledge about optimal care is not applied in clinical practice. A ‘gap analysis’ is an initial research activity undertaken when quantifying the gap between existing knowledge and clinical practice. The purpose of this presentation is to describe outcomes of a gap analysis conducted in lung cancer and priority setting focus groups held with oncology health professionals. This research is being conducted by Sydney Catalyst, a Translational Cancer Research Centre that brings together teams of clinicians and researchers from more than 20 member organisations across NSW, Australia, for the purpose of facilitating rapid translation of scientific evidence into clinical practice and policy.

      Methods
      A systematic approach was used to examine the evidence across the lung cancer patient journey. Data sources included international and national clinical practice guidelines, systematic reviews and meta-analyses, and research from peer reviewed publications, including population-based patterns of care studies and data linkage studies. We also conducted a descriptive analysis of data from clinical cancer registries and administrative databases used in the local setting of Sydney and regional NSW, Australia, to determine what gaps were locally relevant. All data sources were reviewed and synthesised to create the list of evidence-practice gaps. The gaps are presently being tested in three focus groups in urban and regional cancer services in NSW, Australia. Focus group participants include specialists in lung and thoracic oncology, medical, nursing, allied health and supportive care health professionals. The purpose of these focus groups is to conduct a priority setting exercise, where clinicians can rate the relevance of gaps to the local context and agree on which gaps should first be addressed in any subsequent research projects.

      Results
      Seven evidence-practice gaps were identified across the patient journey (from initial presentation and diagnosis through to palliative care). We analysed 2008 data from one local hospital for all lung cancer patients (N=329) and found that local patterns of care appear to be consistent with those previously observed in a NSW patterns of care study. This assists in demonstrating that gaps identified at the population level are also present in local health care settings and strengthens a rationale for developing collaborative lung cancer specific research projects that engage clinicians and researchers. The analysis and outcomes of focus groups will be presented, along with a critical appraisal of the gap analysis methodology and show how this approach in lung cancer is relevant to other tumour groups and health conditions.

      Conclusion
      A gap analysis enables researchers and clinicians to identify where deficiencies exist between published research evidence and optimal patient care. By drawing together and synthesizing data from multiple sources of evidence, identifying gaps and setting priorities with local health professionals, we believe we can address the goal of more rapidly translating evidence into practice.

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    P1.25 - Poster Session 1 - Nurses (ID 248)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Nurses
    • Presentations: 1
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      P1.25-002 - Testing the feasibility of a lung cancer nurse coordination model during early treatment: phase II study (Clinical Trial in Progress) (ID 1124)

      09:30 - 16:30  |  Author(s): K. White

      • Abstract

      Background
      To develop adequate self-care strategies, patients with lung cancer and their families are in need of emotional, informational and behavioural supportive care. Supportive care in cancer can reduce symptom burden and improve patients and their families self-management skills. As lung cancer incidence continues to rise, and increased attention is given to early diagnosis, research on early involvement of lung cancer nurse (LCN) in care, the feasibility and impact on patient outcomes is needed. The primary aim of this study is to assess the feasibility and acceptability of a LCN model of care commenced during first line of chemotherapy, and the impact on patient self-reported changes in self-efficacy, symptoms and supportive care needs. In addition perceived barriers and facilitators for the application of the LCN model will be examined.

      Methods
      An exact single-stage phase II design will be conducted. Lung cancer patients with planned chemotherapy with or without radiotherapy will be recruited at the thoracic cancer center in a Swiss University Hospital. The LCN model of care consists of two face-to-face consultations alternating with two telephone consultations during first line of chemotherapy. LCN consultations will comprise focused assessment of physical and psychological symptoms, information (printed and oral) about disease and its treatment, therapeutic education concerning strategies to manage physical and psychosocial symptoms and review of available support resources. Participants will be invited to complete the validated patient reported Lung Cancer Symptom Scale, Supportive Care Needs Screening Tool 9 and Self-Efficacy Scale for Lung Cancer. Study data will be collected at baseline (day 1 of 1[st] chemotherapy cycle), time 1 (week 3 of 2[nd] cycle) and time 2 (week 3 of 3[rd] cycle). Participants will be categorized as compliant if they complete all their scheduled LCN consultations and questionnaires. For a 5% probability of accepting a poor feasibility (alpha) and a 20% probability of rejecting an acceptable feasibility (beta) we then need to enroll 71 patients. Feasibility will be considered as acceptable for further studies if at least 36 patients will be compliant. Secondary outcomes will be analyzed descriptively for each variable (self-efficacy, symptoms and supportive care needs) across each time point. At the end of quantitative data collection, a focus group will be conducted to explore acceptability of the new role among health professionals working with the LCN in order to identify perceived barriers and facilitators for collaborative work with the new role.

      Results
      N.A.

      Conclusion
      This project is expected to have direct impact on enhancing the quality of supportive care for patients with lung cancer. Findings will provide evidence for refining the LCN model prior to embarking on a full-scale evaluation using a comparative experimental design. Furthermore, phase II designs have rarely been applied to psycho-social interventions. This method could give new insights to the nursing and allied health professionals how to investigate the efficacy and feasibility as well as the needed intensity of newly developed interventions in order to improving supportive care in oncology.