QLIF-06. DESIGN AND IMPLEMENTATION OF A SURVIVORSHIP PROGRAMME IN AN UNSELECTED COHORT OF NEWLY DIAGNOSED BRAIN TUMOUR PATIENTS: FEASIBILITY AND APPLICATION OF ROUTINE HOLISTIC NEEDS ASSESSMENT

Abstract

BACKGROUND: The importance of survivorship in oncology care is increasingly recognised. This project aimed to evaluate the feasibility and utility of routine holistic needs assessment (HNA) and use concerns identified to inform the design of health and well‐being events. METHODS: A 48‐item neuro‐oncology HNA was offered to all new brain tumour patients diagnosed January‐June 2016. HNA was repeated at routine clinic visits at treatment completion and 1‐year post‐diagnosis. Patients ranked each item from 1(low) to 10(high). Two thresholds 4 and 7 were used to identify percentage patients' specific concerns. RESULTS: 104/154 newly‐diagnosed patients completed HNA at diagnosis (1st HNA), 48/104 post‐treatment (2nd HNA). 32/48 remain potentially eligible at 12 months (3rd HNA). Total:1st HNA:2nd HNA numbers by diagnostic groups were: Grade IV:85:55:36; Grade III:11:8:4, Low grade:18:12:4, Meningioma:33:26:5, other:6:3:0. Staff time required for each HNA completion was 15 minutes preparation and 20‐90 minutes with the patient. Highest ranking concerns (scored7/10) at 1st HNA were common to all groups and included fatigue (26% of all patients), worry/anxiety (23%) fear of recurrence (22%), transport (21%). At 2nd HNA, fatigue and fear of recurrence were reported as 7/10 by 35% and 27% of patients respectively; 21% and 19% now also identified mobility and appearance as areas of high concern. No significant differences were seen in nature of concerns between different diagnostic groups. Longitudinally, fatigue remained the most frequently reported concern, followed by fear/worry/anxiety and loss of memory/concentration. Results were used to inform the content of a highly successful all‐day survivorship event in November 2016. CONCLUSION: Concerns identified were common to all diagnoses indicating that a common survivorship programme may be appropriate early in the pathway for patients with tumours of all grades. Fatigue was the most commonly reported concern; the value of 3 different fatigue interventions is to be compared in a randomised‐controlled trial.