Protocol for the CHEST Australia Trial: a phase II randomised controlled trial of an intervention to reduce time-to-consult with symptoms of lung cancer

• Published in: BMJ open 2015-01, Vol.5 (5), p.e008046-e008046
• Main Authors: Murray, Sonya R, Murchie, Peter, Campbell, Neil, Walter, Fiona M, Mazza, Danielle, Habgood, Emily, Kutzer, Yvonne, Martin, Andrew, Goodall, Stephen, Barnes, David J, Emery, Jon D
• Format: Article
• Language: English
• Subjects: Aged; Australia; Chronic obstructive pulmonary disease; Clinical outcomes; Cost analysis; Cost control; Diagnostic Self Evaluation; Early Detection of Cancer; Female; General practice / Family practice; Health Behavior; Humans; Intervention; Lung cancer; Lung Neoplasms - complications; Lung Neoplasms - diagnosis; Lung Neoplasms - etiology; Male; Middle Aged; Mortality; Nurses; Patient Acceptance of Health Care; Perceptions; Primary Health Care; Referral and Consultation; Research Design; Self Care; Sensitivity analysis; Smoking - adverse effects; Spirometry; Studies; Thorax
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2015-008046

Introduction Lung cancer is the most common cancer worldwide, with 1.3 million new cases diagnosed every year. It has one of the lowest survival outcomes of any cancer because over two-thirds of patients are diagnosed when curative treatment is not possible. International research has focused on screening and community interventions to promote earlier presentation to a healthcare provider to improve early lung cancer detection. This paper describes the protocol for a phase II, multisite, randomised controlled trial, for patients at increased risk of lung cancer in the primary care setting, to facilitate early presentation with symptoms of lung cancer. Methods/analysis The intervention is based on a previous Scottish CHEST Trial that comprised of a primary-care nurse consultation to discuss and implement a self-help manual, followed by self-monitoring reminders to improve symptom appraisal and encourage help-seeking in patients at increased risk of lung cancer. We aim to recruit 550 patients from two Australian states: Western Australia and Victoria. Patients will be randomised to the Intervention (a health consultation involving a self-help manual, monthly prompts and spirometry) or Control (spirometry followed by usual care). Eligible participants are long-term smokers with at least 20 pack years, aged 55 and over, including ex-smokers if their cessation date was less than 15 years ago. The primary outcome is consultation rate for respiratory symptoms. Ethics and dissemination Ethical approval has been obtained from The University of Western Australia's Human Research Ethics Committee (RA/4/1/6018) and The University of Melbourne Human Research Committee (1 441 433). A summary of the results will be disseminated to participants and we plan to publish the main trial outcomes in a single paper. Further publications are anticipated after further data analysis. Findings will be presented at national and international conferences from late 2016. Trial registration number Australian New Zealand Clinical Trial Registry ACTRN 1261300039 3752.