Patients with colorectal cancer experience considerable symptom load including physical and psychological morbidity, and unmet social needs even years after completing treatment. There is evidence that patient centred proactive approaches for needs assessment alongside management strategies may result in the needs addressed.
The primary aim of this GP delivered supportive approach, the SATp intervention, was to provide assessments and address needs of colorectal cancer patients with long-term needs following cancer treatment.
A total of 66 participants with localised colorectal cancer were enrolled into the SAT-p intervention. Participants were surveyed monthly for six months using a validated measure – self assessment tool for patients (SATp) and encouraged to visit a general practitioner (GP) with a copy of the SATp. General practitioners’ notes were then reviewed for management actions taken when participants presented SATp in a consultation.
Of 66 patients who completed the follow-up study, 86% visited a GP at least once. A total of 547 needs were identified (median 7; IQR [3-12.25]). Patients with physical needs utilised GP services more compared to those with social or psychological needs (p=0.054). Psychological functioning was significantly (p<0.01) improved by 6 months. There were non-statistically significant improvements in the physical and social functioning. GP consultations resulted in a total of 78 GP actions. Of these, 52/78 (44%) were prescriptions; 17/78(22%), investigations and 9/78(11.5%) were referrals. Prescriptions were mostly antidepressants (9/25 -36%), sedatives (6/25 -24%) and analgesics (3/25-12%). The chance of getting a prescription was the same whether patient had a physical (p=0.90) or psychological need (p=0.41).
The SAT-p intervention was found to be feasible and acceptable to patients. Regular use of needs assessment measures is an effective way to identify patient unmet needs and aid doctor patient consultation. GPs play and important role in supporting patients during surveillance.