Early cancer diagnosis and community pharmacy in deprived areas – an online survey

Problem

The key to cancer treatment success and better clinical outcomes is early detection. Clinical outcomes of cancer are worse in deprived areas. The role of general practice is essential, as patients with symptoms that could potentially be symptoms of malignancy, and most commonly present in primary care. However, they may approach other healthcare providers first, for example, community pharmacies.Community pharmacies are accessible, and they are already contributing to relieving the pressure on general practice. The positive pharmacy care law states that in deprived areas, patient access to community pharmacies within a 20-minute walk is better, when compared to more affluent areas, and overall represents better geographical access when compared to GP surgeries.We are currently conducting a systematic review that summarises the evidence regarding the role of community pharmacy in early cancer detection. The current practice of community pharmacy staff in England is not well explored.

Approach

We designed an online survey for customer-facing community staff members, which is currently being piloted. The study aims to explore the current practice of community pharmacy staff when dispensing over-the-counter medication to customers for the treatment of symptoms that could indicate potential gastrointestinal, urinary tract, prostate or lung cancer. The survey was designed using the Qualtrics online survey tool.Objectives:1. To conduct an online survey with customer-facing staff members in community pharmacies to explore their current practice regarding asking customers about their symptoms when they seek to purchase over-the-counter medication for symptoms that could be symptoms of cancer. 2. To explore factors relating to usual practice. 3. To explore if usual practice differs between deprived area-serving community pharmacies and more affluent area-serving community pharmacies. 4. To use findings to inform future research needs about the role of community pharmacies in early cancer detection. We will work together with Local Pharmaceutical Committees in Cornwall, Devon, Somerset and Greater Manchester to distribute the survey. They will e-mail the information to the NHS e-mail addresses of community pharmacies and the invitation will be then forwarded to customer-facing staff members’ e-mail addresses.Given the exploratory nature of the survey, the key factor when considering sample size is the precision of any estimates of the percentages of staff asking about symptoms that could indicate cancer. With responses from over 450 pharmacies, the 95% confidence intervals on a percentage of 25% would be 21-29%.

Findings

We will present preliminary results at the conference.

Consequences

An online survey of community pharmacy staff is a not widely used research approach. Our findings will inform the current practice of community pharmacy staff about their approaches to explore potential cancer related symptoms when customers purchase over-the-counter medication. Findings will inform future research and policy making.