Using patient-reported outcome measures to deliver enhanced supportive care to people with lung cancer: feasibility and acceptability of a nurse-led consultation model

Support Care Cancer. 2018 Nov;26(11):3729-3737. doi: 10.1007/s00520-018-4234-x. Epub 2018 May 19.

Abstract

Purpose: Developing new supportive/palliative care services for lung cancer should encompass effective ways to promptly identify and address patients' healthcare needs. We examined whether an in-clinic, nurse-led consultation model, which was driven by use of a patient-reported outcomes (PRO) measure, was feasible and acceptable in the identification of unmet needs in patients with lung cancer.

Methods: A two-part, repeated-measures, mixed-methods study was conducted. Part 1 employed literature reviews and stakeholder focus group interviews to inform selection of a population-appropriate needs assessment PRO measure. In Part 2, lung cancer nurse specialists (CNS) conducted three consecutive monthly consultations with patients. Recruitment/retention data, PRO data, and exit interview data were analysed.

Results: The Sheffield Profile for Assessment and Referral to Care was the PRO measure selected based on Part 1 data. Twenty patients (response rate: 26%) participated in Part 2; 13 (65%) participated in all three consultations/assessments. The PRO measure helped patients to structure their thinking and prompted them to discuss previously underreported and/or sensitive issues, including such topics as family concerns, or death and dying. Lung CNS highlighted how PRO-measures-driven consultations differed from previous ones, in that their scope was broadened to allow nurses to offer personalised care. Small-to-moderate reductions in all domains of need were noted over time.

Conclusions: Nurse-led PRO-measures-driven consultations are acceptable and conditionally feasible to holistically identify and effectively manage patient needs in modern lung cancer care. PRO data should be systematically collected and audited to assist in the provision of supportive care to people with lung cancer.

Keywords: Lung cancer; Needs assessment; Nurse specialist; Patient-reported outcome (PRO) measures; Supportive care; Unmet needs.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Feasibility Studies
  • Female
  • Focus Groups
  • Hospice and Palliative Care Nursing* / methods
  • Hospice and Palliative Care Nursing* / organization & administration
  • Humans
  • Leadership
  • Lung Neoplasms / nursing*
  • Lung Neoplasms / therapy
  • Male
  • Middle Aged
  • Needs Assessment
  • Nurse Clinicians* / organization & administration
  • Nurse Clinicians* / standards
  • Patient Acceptance of Health Care*
  • Patient Reported Outcome Measures*
  • Pilot Projects
  • Practice Patterns, Nurses' / organization & administration
  • Practice Patterns, Nurses' / standards
  • Referral and Consultation* / organization & administration
  • Referral and Consultation* / standards