Optimization of a Quality Improvement Tool for Cancer Diagnosis in Primary Care: Qualitative Study

Simple item page
dc.contributor.authorChima, Sophie
dc.contributor.authorMartinez-Gutierrez, Javiera
dc.contributor.authorHunter, Barbara
dc.contributor.authorManski-Nankervis, Jo-Anne
dc.contributor.authorEmery, Jon
dc.date.accessioned2025-01-20T21:02:31Z
dc.date.available2025-01-20T21:02:31Z
dc.date.issued2022
dc.description.abstractBackground: The most common route to a diagnosis of cancer is through primary care. Delays in diagnosing cancer occur when an opportunity to make a timely diagnosis is missed and is evidenced by patients visiting the general practitioner (GP) on multiple occasions before referral to a specialist. Tools that minimize prolonged diagnostic intervals and reduce missed opportunities to investigate patients for cancer are therefore a priority.
dc.description.abstractObjective: This study aims to explore the usefulness and feasibility of a novel quality improvement (QI) tool in which algorithms flag abnormal test results that may be indicative of undiagnosed cancer. This study allows for the optimization of the cancer recommendations before testing the efficacy in a randomized controlled trial.
dc.description.abstractMethods: GPs, practice nurses, practice managers, and consumers were recruited to participate in individual interviews or focus groups. Participants were purposively sampled as part of a pilot and feasibility study, in which primary care practices were receiving recommendations relating to the follow-up of abnormal test results for prostate-specific antigen, thrombocytosis, and iron-deficiency anemia. The Clinical Performance Feedback Intervention Theory (CP-FIT) was applied to the analysis using a thematic approach.
dc.description.abstractResults: A total of 17 interviews and 3 focus groups (n=18) were completed. Participant themes were mapped to CP-FIT across the constructs of context, recipient, and feedback variables. The key facilitators to use were alignment with workflow, recognized need, the perceived importance of the clinical topic, and the GPs' perception that the recommendations were within their control. Barriers to use included competing priorities, usability and complexity of the recommendations, and knowledge of the clinical topic. There was consistency between consumer and practitioner perspectives, reporting language concerns associated with the word cancer, the need for more patient-facing resources, and time constraints of the consultation to address patients'worries.
dc.description.abstractConclusions: There was a recognized need for the QI tool to support the diagnosis of cancer in primary care, but barriers were identified that hindered the usability and actionability of the recommendations in practice. In response, the tool has been refined and is currently being evaluated as part of a randomized controlled trial. Successful and effective implementation of this QI tool could support the detection of patients at risk of undiagnosed cancer in primary care and assist in preventing unnecessary delays.
dc.fuente.origenWOS
dc.identifier.doi10.2196/39277
dc.identifier.eissn2561-326X
dc.identifier.urihttps://doi.org/10.2196/39277
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/93047
dc.identifier.wosidWOS:000854086000009
dc.issue.numero8
dc.language.isoen
dc.revistaJmir formative research
dc.rightsacceso restringido
dc.subjectcancer
dc.subjectprimary health care
dc.subjectdiagnosis
dc.subjectquality improvement
dc.subjectclinical decision support tool
dc.subjectgeneral practice
dc.subjectpilot
dc.subjectfeasibility
dc.subjectClinical Performance Feedback Intervention Theory
dc.subject.ods05 Gender Equality
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa05 Igualdad de género
dc.subject.odspa03 Salud y bienestar
dc.titleOptimization of a Quality Improvement Tool for Cancer Diagnosis in Primary Care: Qualitative Study
dc.typeartículo
dc.volumen6
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
Files
Collections
Artículos de revistas