Nurse navigation, symptom monitoring and exercise in vulnerable patients with lung cancer: Feasibility of the NAVIGATE intervention

We developed the Navigate intervention to improve survival among vulnerable lung cancer patients. In this intervention-only study, we examined feasibility in terms of recruitment , retention , attendance , adherence, and acceptability to specify adjustments to study procedures and intervention components prior to a randomized trial. The Navigate intervention includes nurse navigation, patient-reported outcomes, and physical exercise. Patients > 18 years old, diagnosed with non-small cell lung cancer at any stage, with performance status < 2 and vulnerable according to a screening instrument were included. Seventeen (56%) out of 30 screened patients were considered vulnerable, 14 (82%) accepted participation, and 3 (21%) were excluded due to ineligibility, leaving 11 patients. Four patients (36%) died during follow-up and 3 (43%) were retained. All 11 patients participated in nurse sessions (mean 16, range 1–36) with 88% attendance and dialogue tools being applied in 68% of sessions. Ninety-one percent responded to PROs (mean 9, range 1-24) with 76% attendance and 100% adherence and 55% participated in exercise sessions with 58% attendance and 85% adherence. We identified important barriers primarily related to transportation, but overall acceptability was high. The Navigate intervention was feasible with high participation, acceptability and satisfactory adherence. Retention and exercise attendance were low, which resulted in adjustments.