Patient experience and satisfaction with symptomatic faecal immunochemical testing: an explanatory sequential mixed-methods evaluation

Abstract

Background: Recent evidence suggests that faecal immunochemical testing (FIT) can rule out colorectal cancer in symptomatic adults. To date, there is little research exploring experiences of FIT for this population. Aim: To explore patient experience and satisfaction with FIT in an ‘early adopter’ site in England. Design: We used an explanatory sequential mixed-methods approach combining mailed quantitative surveys with semi-structured telephone interviews. Methods: Multivariate logistic regression was used to analyse quantitative data. Thematic analysis was used to assess qualitative transcripts. Results: The survey had 260 respondents and found satisfaction with FIT was high (88.7%). Compared with test satisfaction, the proportion of respondents satisfied with GP consultation, and how they received their results, was lower (74.4% and 76.2%, respectively). Multivariate analysis showed increased area-level deprivation and not receiving an explanation of the purpose of the test were associated with lower satisfaction with GP consultation (both P-values<0.05), while increased area-level deprivation and not receiving results from the GP were associated with lower satisfaction with receiving results (both P-values<0.05). Interviews with respondents (n=20) helped explain the quantitative results. They revealed that “not knowing the purpose of the test” caused “anxiety” and “confusion”, which led to dissatisfaction. “Not receiving results from GP” was considered “unacceptable”, as this left patients with a “niggling doubt” and lack of diagnosis, or assurance that they did not have cancer. Conclusion: Patient satisfaction with symptomatic FIT is high. Efforts to improve satisfaction should focus on ensuring patients understand the purpose of the test and always receive their test results.

Symptomatic presentation of cancer in primary care: a scoping review of patients’ experiences and needs during the cancer diagnostic pathway

“… 36 There were also suggestions around who research should be carried out with, such as patients who are not referred to secondary care, 48 family members, 34 41 primary care HCPs, 31 32 34 36 41 47 52 57 specific population subgroups 36 and members of the community. 43 In terms of topics for future research, suggestions included exploring HCP consultation behaviour 41 and how to improve patient HCP communication, 30 sometimes with a focus on inequality 44 46 ; best practice for safety netting 56 ; comparing patient and HCP symptom perception 40 41 ; researching ways to improve the cancer care pathway. 33 42 52 55 56 This may include ways of accessing diagnostic tests 37 52 ; exploring quantitatively the impact of the diagnostic route 53 ; investigating why some patients present at the emergency department 51 and the role of health literacy 49 and GP characteristics.…”

“…After deduplication and removal of studies which did not meet the inclusion criteria, 18 studies remained. [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] In the grey literature search, six reports were assessed for inclusion, and three were retained. [47][48][49] Six papers were included following the citation and references search.…”

Rejection of Fecal Immunochemical Tests Within the Lower Gastrointestinal Diagnostic Pathway: A Cohort Study

“…Previous research has shown that patient satisfaction with symptomatic FIT is high, 17 however a paucity of research exists examining the accurate completion of submitted FIT samples. Two previous studies from the USA showed FIT rejection rates between 17% and 42% in asymptomatic (screening) populations.…”

Can we do better? A qualitative study in the East of England investigating patient experience and acceptability of using the faecal immunochemical test in primary care

“…Since symptomatic populations have varied (and higher) levels of risk compared with an asymptomatic screening population, evidence on the patients’ experience of care when and after doing FIT is crucial. To our knowledge, only two other studies have reported on symptomatic patients’ views of FIT; one quantitative study focusing on usability and acceptability,27 and one mixed-methods study evaluating patient experience and satisfaction 29…”

“…To our knowledge, only two other studies have reported on symptomatic patients’ views of FIT; one quantitative study focusing on usability and acceptability, 27 and one mixed-methods study evaluating patient experience and satisfaction. 29 …”