19 The development of a patient engagement intervention to improve lung cancer patients' and carers' experience of and engagement in their recommended lung cancer care pathway in rural, coastal, and urban settings

Abstract

Introduction Achieving optimal outcomes in lung cancer care relies upon the patient's capability, opportunity, and motivation to engage in their recommended care pathway. Engagement is impacted by personal factors (i.e. patient characteristics and circumstances) and contextual factors related to geographic setting. This research outlines the development of a patient engagement intervention designed to improve patient and carer experiences of, and participation in, their recommended lung cancer pathway in rural, coastal, and urban settings. Methods A pragmatic, evidence-and theory-based intervention development process was conducted between November 2023 and December 2024. Evidence to inform the iterative development of the intervention was generated across three workstreams: 1) rapid evidence synthesis of lung cancer patient engagement interventions, 2) interviews with patients (n = 55) and carers (n = 31) from rural, coastal, and urban settings, and 3) health professional and PPIE workshops. Triangulation and analysis informed by the COM-B model identified modifiable behavioural factors to target with an intervention. Results In the evidence synthesis of 34 interventions, informational/educational approaches were the most common and demonstrated improvements in key outcomes. Barriers and enablers to intervention development and implementation were identified. Interviews highlighted patients' limited understanding of the lung pathway and healthcare system which impacted their capability and opportunity to engage with their diagnostic test and treatments. Some patients did not recognise the importance of tests and treatments, or their motivation to accept treatments was impacted by pre-conceived ideas. Workshops with professional and PPIE stakeholders helped refine intervention development and implementation plans. Findings informed the iterative development of an interactive guide which maps the lung cancer care pathway for patients and carers and signposts relevant information and local resources throughout. Conclusion This patient engagement intervention aims to support lung cancer patients to optimally engage in their recommended care pathway. The intervention will be tested in clinical settings to evaluate acceptability. Disclosure Michael D Peake is a Specialist Clinical Advisor to Cancer Research UK who have funded the study.