Abstract

Workshop presentation for GP Educators conference- 14/01/16
Workshop on service user and practitioner perspectives of QCancer use in primary care consultations

Researchers:
Joseph Akanuwe, PhD Student, Community and Health Research Unit, University of Lincoln.
Professor Niro Siriwardena, Professor of Primary and Pre Hospital Health Care and Director of the Community and Health Research Unit, University of Lincoln.
Dr Sharon Black, Director of Nurse Education, University of Lincoln
Professor Sarah Owen, Pro Vice Chancellor and Head of the College of Social Science, University of Lincoln.

Introduction
QCancer is a novel cancer risk assessment tool that combines risk factors and symptoms to estimate an individual’s risk of developing cancer within two years. This study explored the perspectives of patients and primary care practitioners about using QCancer in the primary care consultation.

Methods
We used qualitative methods to conduct individual and focus group interviews with service users recruited from the general public and primary care practitioners (GPs and nurses) recruited from general practices in Lincolnshire (a large rural county in England) until data saturation was achieved. The qualitative data were transcribed verbatim and analysed using the Framework approach.

Results
Thirty-six participants, 19 service users (aged between 21-71 years) and 17 practitioners (aged between 33 and 55 years) were interviewed. They expressed a range of views:

Implications of quantifying cancer risk using QCancer including:
• Potential conflict with current cancer guidelines
• High risk symptoms would need referral for further investigation whatever the quantified risk.

QCancer is potentially useful for cancer consultations
• Quantifying cancer risk
• Supporting decision-making
• Identifying, raising awareness of and modifying health behaviours
• Improving processes and speed of assessment and treatment, and
• Personalising care.

Need to address communication issues related to use of QCancer
• Tailoring visual representation of risk
• Openness and honesty
• Informing and involving patients in use of QCancer and
• Providing time for listening, informing, explaining and reassuring in the context of a professional approach

Potential challenges to uptake of QCancer in general practice
• Additional time required
• Unnecessary worry generated by false positives
• Potential for over-referral and strain on resources
• Practitioner scepticism about using the new tool, and
• The need for evidence of effectiveness before introducing QCancer in patient consultations.

Conclusion
Service users and primary care practitioners perceived that:
• QCancer would support and individualise decision making
• Help identify and modify health behaviours
• Increase knowledge
• Improve the processes and speed of cancer assessments and treatments and facilitate personalised care of cancer.
• Communication needs of users and potential barriers for both users and practitioners will need to be considered in planning for QCancer use in general practice consultations.