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Design and implementation of novel pharmacy service models for older cancer survivors

Kumud Kantilal, University of East Anglia

Aim: 

This project aims to find out how community pharmacy teams can better support older people who have finished their cancer treatment, to self-manage the longer-term physical and emotional effects of their cancer treatment. 

Background: 

The number of older people successfully completing cancer treatment is growing but the treatment can have longer-term effects on a person’s physical and emotional health.  We are not doing very well with supporting people with these problems such as long-term diarrhoea and depression.  Supporting people to self-manage these problems by giving them the confidence and capability to get the right help when they need it and make lifestyle changes to promote health may make a difference.  It has worked well for other long-term conditions like diabetes and heart disease.  We want to know whether we can make it work for older cancer survivors and provide the service from community pharmacies.  To give us the best chance of making it work, we want to find out how self-management works, for whom and in what circumstances. 

Method: 

We plan to use realist synthesis which takes information from published research and non-research documents like reports from organisations about new cancer services to find out what worked, for whom and in what circumstances. There are five stages to the review: istages 1 and 2 we want to find out how self-management is thought to work. To do this, we will undertake a brief review of the literature and come up with some initial statements for how we thing they work.  We will present these ideas to a range of experts, including patients, family carers and practitioners who provide care to cancer patients.  After refining these initial ideas, we will use them to structure the next stage of the review. 

In stages 3 to 5we will undertake a more detailed literature search to see if the statements developed in stages 1 and 2 are supported by the evidence. We will explore what the literature tells us about the different elements of self-management support and how it is linked to particular situations and outcomes. We will hold a second workshop with our experts to discuss the findings, identify common themes in the evidence and refine the statements developed in stages 1 and 2 about how self-management support can work and specifically look at how they can work in community pharmacy.  

Results from Phase 1 will then be used in phase 2 of the project to see if the findings make sense to our stakeholders and discuss what would be necessary to implement them in community pharmacy practice. We will produce recommendations in phase 3 designed to help community pharmacies delivering and planning self-management support services and inform the development of future research studies.  

This project was due to run from October 2018 to December 2019