Sinan Eccles, Amy Smith, Claire Wright and Chris Coslett (Wales Cancer Network) and Jean Engela and Nicole Abel (Cardiff University)
Wales Cancer Network and Cardiff University
Targeted lung cancer screening has been recommended by the UK National Screening Committee. Effective screening depends on accurate and efficient identification of the target population.
The screening process involves identifying current and ex-smokers (“ever-smokers”) in a target age range, followed by risk assessment +/- low-dose CT screening.
GP records can be used to identify ever-smokers but the completeness of this data is uncertain and updating of records can be resource-intense.
Project Aims and Objectives:
Search GP records to assess the completeness of smoking data (recorded as “tobacco codes”).
Develop a toolkit for GP practices to update missing smoking data via a text message system.
Following proof-of-concept work, a toolkit was developed for the VISION360 patient administration system (used by 54% of GP practices in Wales, with the remainder using EMIS) giving step-by-step instructions for practices.
12 practices participated in the first phase of the project, assessing the completeness of smoking data and testing the toolkit. Following an interim analysis, revisions were made to the toolkit and a streamlined version was tested by a further two practices.
All participating practices successfully used the toolkit to update smoking records. During the first phase of testing, use of the toolkit increased data completeness from 96.5% to 98.0% (+1.5% absolute change; 331 additional tobacco codes recorded).
The majority of feedback reported that the toolkit was easy to use. Issues identified at the interim analysis included data errors related to manual calculation of results by users, and frustration with instructions asking to repeat previous steps.
The revised streamline version of the toolkit was successfully used by two further practices, taking practice managers an average of 30 minutes to complete (range 20-40 minutes).
An improvement in data completeness of +1.5% across Wales would equate to an additional 5,934 people across Wales being eligible for targeted lung cancer screening who may otherwise have been missed.