Effective clinical cancer treatment, care and management for people with comorbid cancer and dementia: understanding population demographics and intervention priorities and outcomes

Study Code / Acronym
CanDem-Int
Award Number
PB-PG-0816-20015
Programme
Research for Patient Benefit
Status / Stage
Completed
Dates
2 May 2018 -
1 August 2019
Duration (calculated)
01 years 02 months
Funder(s)
NIHR
Funding Amount
£153,452.00
Funder/Grant study page
NIHR
Contracted Centre
Leeds Teaching Hospitals NHS Trust
Contracted Centre Webpage
Principal Investigator
Professor Claire Surr
PI ORCID
0000-0002-4312-6661
WHO Catergories
High quality epidemiological data
Risk reduction intervention
Tools and methodologies for interventions
Understanding risk factors
Disease Type
Dementia (Unspecified)

CPEC Review Info
Reference ID115
ResearcherReside Team
Published12/06/2023

Data

Study Code / AcronymCanDem-Int
Award NumberPB-PG-0816-20015
Status / StageCompleted
Start Date20180502
End Date20190801
Duration (calculated) 01 years 02 months
Funder/Grant study pageNIHR
Contracted CentreLeeds Teaching Hospitals NHS Trust
Contracted Centre Webpage
Funding Amount£153,452.00

Abstract

Cancer and dementia are chronic conditions affecting a significant number of older people. The addition of a co/multi-morbidity alongside cancer or dementia creates treatment and care complexity and poorer patient outcomes. Research on the prevalence of co-morbid dementia and cancer is limited; no studies describe the size or characteristics of this population with little understood about their clinical needs, potential interventions or outcomes. Identifying cancer treatment and care intervention priorities and key outcomes for this population; – Understanding the key issues and challenges in conducting research in this population to inform the design of future research. Research Questions: It will answer the following research questions: 1. What are the clinical and service use characteristics of the population of people with comorbid cancer and dementia? 2.What problems, priorities and best practices do people with comorbid cancer and dementia, their families/supporters and staff identify in relation to cancer treatment, care and management of people with comorbid cancer and dementia within NHS services? 3. What do these data tell us regarding optimal research design and implementation, to inform the planning and conduct of future research and intervention studies in this population? Research Plan: The study will consist of two inter-related work packages (WPs). WP1 will identify the characteristics of people with comorbid cancer and dementia, WP2 will examine the experiences and intervention priorities for people with comorbid cancer and dementia, their family/supporters and NHS staff. Data from the WPs will be combined to identify priorities, optimal design and implementation for future research and services in this population. WP1 is an epidemiological, cross-sectional observational study of patients aged 50 and over with a Quality Outcomes Framework (QoF) registered diagnosis of dementia, cancer or both conditions. These data have been obtained through ResearchOne, a database of de-identified clinical and administrative routine data drawn from the electronic patient records of 391 GP practices in England. It will identify the size, demographic, clinical and service use characteristics of people with comorbid cancer and dementia compared to those with only one of these conditions using multi-level modelling to take account of the hierarchical data structure (patients nested within practices), allowing identification of characteristics associated with having both conditions, predictive of service use. WP2 is a qualitative study utilising ethnographic interviews, observations and conversations with people with comorbid cancer and dementia, current or former carers/supporters of this group, and clinicians working in NHS cancer services, to explore experiences of care and improvement priorities. Ethnographic observations and conversations will follow the care pathway experiences of people with co-morbid dementia and cancer across different hospital departments during one or more visits for cancer treatment/care. Targeted observations of general, routine practice will focus on areas of good and problematic practice identified in the interviews and care pathway observations. Data analysis will be an iterative process exploring the content and patterns in the data via triangulation across data sources. Benefits: Outputs from the WPs will be synthesized to identify future research and service delivery priorities, including: identification of priority areas and implications for the design and conduct of future research; raising clinical and research awareness of the needs people with comorbid cancer and dementia; providing the first description of the size and clinical char

Aims

This study aims to address current knowledge gaps by: – Estimating the UK population size and describing the demographic, clinical and service use characteristics of people with comorbid cancer and dementia.