The co-design of a new surveillance protocol for thoracic oncology patients

Lung cancer patients with advanced disease and no active treatment options currently face frequent follow-up visits to the outpatient clinic; associated with significant anxiety, time commitment, and costs. These visits also place considerable strain on the health system. Evidence from other population groups (including people with some cancers and chronic health conditions) suggests virtual or remote follow-up can lead to higher patient satisfaction without negatively impacting on health outcomes such as survival time. The aim of this study was to identify preferences for different surveillance protocols for people with non-curative lung cancers or mesothelioma. A three-phase co-design approach was adopted, including peg boards, semi-structured interviews and a discrete choice experiment (DCE). Findings from the DCE identified a need for reassurance, and the importance of relationship, consistency, and convenience for patients. Participants also identified that their preference for follow-up would be with an oncologist based locally at their primary care practice. Nurse-led and telehealth clinics were also considered acceptable options. Findings informed the design of a feasibility trial of a novel surveillance approach.