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THIS IS A TEST!!!

Group of students collaborating

CANAssess

Using the Needs Assessment Tool-Cancer (NAT-C) developed for use by doctors or other clinicians in GP surgeries to identify and address symptoms and unmet needs of cancer patients and their carers.

LEAD RESEARCHERS

Miriam Johnson

Professor Miriam Johnson

Professor of Palliative Medicine

Dr Flavia Swan

Research Fellow

Joseph Clark

Dr Joseph Clark

Lecturer in Global Palliative Care

TIME FRAME

2015 - 2024

FUNDED BY

About this project

People with cancer need good access to palliative care, but not everyone gets the same access to these services. This can leave some patients with unresolved problems which affect their quality of life.

The purpose of this study was to test whether it was feasible to conduct a large clinical trial of a new needs assessment tool (NAT-C) for clinicians to use with cancer patients in primary care.

The first stage of the study, CANASsess1, was completed in 2019 and the ongoing second stage, CANASsess2 began in 2020.

CANAssess1

We recruited 47 cancer patients and 17 carers from four general practices in Hull to take part in this initial small-scale study. Eleven doctors, nurses, and research support staff also participated in interviews and focus groups to give their views on the NAT-C and the possibility of a larger trial.

At the start of the study nearly three-quarters (72%) of patients had unresolved problems. When the needs assessment tool was used, after one month the proportion of patients with unsolved problems had reduced to just over half (54.8%).

Carers also filled out questionnaires and their unresolved problems also reduced as the study continued.

As well as testing the needs assessment tool we wanted to find out whether the questionnaires we were using were meaningful to people taking part in the study. This would help us select the best questionnaires to use for the large-scale trial, CANAssess2.

Patients, carers and clinicians all supported a larger trial to find out if the NAT-C is effective in reducing patient carer problems. We now have the information we need to be confident that this large-scale trial can be conducted successfully and it will be going ahead from 2020.

Read more about this study in the patient results booklet.

Publications

Clark J, Amoakwa E, Wright-Hughes A, Blenkinsopp J, Currow DC, Meads D, Farrin A, Allgar V, MacLeod M and Johnson M. A cluster randomised trial of a Needs Assessment Tool for adult Cancer patients and their carers (NAT-C) in primary care: A feasibility study. Plos One. 2021.

CANAssess2

Many people with cancer experience a wide range of symptoms and problems across all areas of life. Studies suggest that these symptoms are common but are often not known about or managed by the doctors and nurses caring for them.

The Needs Assessment Tool-Cancer (NAT-C) has been developed for use by doctors or other clinicians in GP Surgeries to identify and address any concerning symptoms and unmet needs of cancer patients and their carers. We will test whether regular use of this tool improves patient care compared with how care is usually provided.

The previous CANAssess1 study showed us that carrying out this study would be possible, and Yorkshire Cancer Research agreed to fund it.

his study is aiming to recruit 850 from 41 GP Practices across Yorkshire and the North East of England. Recruitment ends on 31st August 2023.We are testing if routine use of the Needs Assessment Tool-Cancer (NAT-C) improves patients’ and their carers’ experience compared with usual care.

If the tool proves to be effective in reducing unresolved patient/carer problems, it will set a new standard of care across the whole of the UK, improving the experience of people with cancer and their families.

We are also conducting a short survey and interviews with GPs, practice managers and nurses who are using the NAT-C so we can understand what would help or hinder their use of the NAT-C in clinical practice. These findings will help us devise an implementation strategy for the NAT-C tool to ensure that the new standard of care can be delivered across the UK should trial results be positive.

Outputs

Clark J, Amoakwa E, Wright-Hughes A, Blenkinsopp J, Currow DC, et al. (2021) A cluster randomised trial of a Needs Assessment Tool for adult Cancer patients and their carers (NAT-C) in primary care: A feasibility study. PLOS ONE 16(1): e0245647.

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