What is your current job title and current role?

I have two roles at The Christie NHS Foundation Trust:

 

• Advanced Nurse Practitioner (ANP), and

• Research Associate

 

I currently work 1-day per week as an ANP predominantly on an admissions unit, whereby I review patients who attend the hospital acutely unwell. I autonomously assess, diagnose and create an appropriate management plan for them. I also mentor trainee ANPs, who are undergoing their MSc in Advanced Clinical Practice, and promote their education and development.

 

I was awarded a Clinical Academic development scholarship and work 4-days per week as a Research Associate within the The Christie Patient Centred Research group.

 

I lead on two studies:

 

• Evaluating the impact of Enhanced Supportive Care (ESC) from the perspective of both patient and caregiver, which entails questionnaires and interviews, the goal of which being to ascertain the impact of ESC on quality of life, use of services and symptom management, and 

• In collaboration with a commercial company developing a device that will carry out minimally invasive blood testing for cancer patients in their own home. I project manage this study; organising and co-ordinating focus groups, contributing to data analysis, contributing to protocols and information leaflets, and assisting with submitting amendments and study documents to REC. I also line manage a research assistant.
   

Why are you interested in research and this ARC pre-doctoral fellowship?

I want to develop my own knowledge base so that I can endeavour to improve patient experience. The current pathway for patients with cancer undergoing systemic anti-cancer therapy (SACT) is a blood test on the day of treatment or day(s) prior to scheduled treatment. Some patients require repeat blood tests during the treatment cycle also.
 

Regular blood testing and treatment alterations can have a significant impact on the experience of the person with cancer. Routine blood testing can be associated with considerable stress and discomfort, especially for those with poor venous access. Travelling to a health centre for blood tests adds an additional burden, particularly for those travelling long distances. This is heightened for those having changes in their treatment regimen at short notice such as SACT delays or the lengthening of treatment due to the administration of blood products. Unplanned treatment cancellation or delay also results in additional costs to the health system in terms of potential drug wastage, outpatient and treatment unit allocations, and bed availability. Although having the full spectrum of blood test results including biochemistry available is necessary prior to proceeding with treatment, a number of key treatment decisions are made based on full blood count results alone. Treatment is often cancelled, delayed or dose reduced if there is any evidence of significant myelosuppression.

 

For many patients with cancer, adverse events such as infections, febrile neutropenia and prolonged myelosuppression arise whilst at home. As such, under the current standard of care complications progress unchecked until routine appointments or emergency admissions flag them. Patients often report experiencing critical symptoms at home yet not contacting the oncology team for support/advice. This can lead to emergency admissions, cancellation of SACT or even death.  A potential salutation would be to enable patients to report symptoms and monitor blood counts at home and the information be electronically transferred to the clinical team.

 

Research question

'What is the feasibility of home monitoring of symptoms and blood counts to support cancer patients receiving SACT'?

 

Research summary

This has the potential to transform SACT pathways for patients with cancer. Firstly, for those patients who are receiving SACT and are having their bloods checked prior to each cycle; if they are able to obtain a FBC using the device when at home the day before they are due to attend for treatment, any results which are out of safe parameters, meaning they won’t be able to receive their treatment, will be detected promptly. This is of benefit to the patient in regards to the time, cost and energy of travelling to the hospital that is incurred to be told their treatment is being deferred. Similarly, this early detection of a deferral will have a positive impact upon the treatment unit, promoting efficiency when scheduling patients and avoiding any appointments being left unused.
 
 

How are you currently involved in research in your job role?

Currently I am working within The Christie Patient Centred Research group (CPCR) and lead on two studies. This entails project managing, liaising between clinical and commercial teams, ensuring targets are met, data is collected and processed, and information is disseminated. I recruit patients, caregivers and healthcare professionals to the studies, support participant follow-up as per protocol. I am leading on the qualitative aspects including semi-structured interviews and undertaking data analysis using thematic analysis. I chair and co-ordinate the project steering committees.

 

As a member of the CPCR group I also support other project as required, such as supporting recruitment and data management activities. I am an active member of The Christie Clinical Academic Pathway group and attend the monthly forums where research led by nurses/AHPs is discussed and encouraged. During my time with CPCR I have greatly enhanced by knowledge and skills in clinical research and have had the opportunity to be involved in the whole research process.