Project AMM24

DiSCO – Designing Services for Cancer in Older people

This study designed an intervention to facilitate primary care teams to enable and empower people with unmet needs to better self-manage the long-term consequences of cancer treatment.

Summary

Half of older people effectively self-manage long-term consequences of cancer treatment by accessing appropriate support in a timely manner. For those not self-managing and therefore experiencing unmet physical, emotional, and social needs, primary care teams need to provide additional support.

This programme of research designed an intervention to facilitate primary care teams to enable and empower people with unmet needs to better self-manage the long-term consequences of cancer treatment.

We used a mix of research methods, including:

  • a cross-sectional survey of older people who have completed/are on long-term cancer treatment to understand their self-management needs,
  • a realist review to understand the barriers and enablers to healthcare professionals delivering self-management support to people living with and beyond cancer,
  • focus groups with primary care professionals and workshops with primary care professionals, patient advocates and commissioners to co-design the intervention.

Project Aims

The DiSCO project aimed to:

  • Understand the extent of unmet physical, emotional, and social needs of older people living with long-term problems related to cancer treatment.
  • Use a realist approach to explore what works for whom and in what circumstances in relation to practitioners supporting older people to self-manage long-term problems caused by cancer treatment.
  • Co-design an intervention for practitioners in primary care to identify older people that will benefit from support to self-manage long-term problems related to cancer treatment.

Project Activity

Remote video URL

We conducted a survey of 343 older people with breast, bowel or prostate cancers, during February and March 2019, across six NHS hospitals. The survey explored the long-term impact of cancer treatment on older peoples’ physical health, emotional wellbeing, and social life.  

We have completed a realist review of the literature to understand what enables healthcare professionals to support people living with and beyond cancer to self-manage.

We convened three online focus groups in January 2021 with 22 community pharmacists, general practitioners, and practice nurses to identify the key barriers to supporting older people to self-manage long-term problems caused by cancer treatment. We convened three online co-design workshops in February and March 2021, with key stakeholders, to develop an intervention to facilitate primary care teams to support older people to self-manage long-term problems caused by cancer treatment.    

What we found and what this meant 

The findings of the study were shared through:

  • Conference presentations aimed at health and social care practitioners who work with older people living with and beyond cancer.
  • Publication of papers in academic journals.
  • Study report/briefing papers for relevant organisations e.g., Pharmacy Research UK, Macmillan Cancer Support, Big C, Norfolk’s Cancer Charity.  
  • Summaries for study participants
  • Social media e.g., Twitter, blogs and websites run by the University of East Anglia

The intervention developed has the potential to support General Practices in England to deliver the Quality and Outcomes Framework (QOF) indicators for cancer.

Who was involved?

Principle Investigator

Kumud Kantilal, University of East Anglia: k.kantilal@uea.ac.uk

Researchers and institutions

Debi Bhattacharya, University of East Anglia

Wendy Hardeman, University of East Anglia

Jo Taylor, University of York

Matthew Small, Norfolk and Norwich University Hospitals NHS Foundation Trust

Eleni Karapanagiotou, Guy’s and St Thomas’ NHS Foundation Trust

AMM24