Patients with lung cancer live longer, avoid unnecessary hospital admissions and cope better with treatment when cared for by specialist nurses, according to a new study.
The research by the University of Nottingham and London South Bank University, which looked at more than 100,000 lung cancer cases, found many patients fared better if they received an assessment and care from a specialist nurse.
“It is clear that receiving care from a lung nurse specialist is fundamental to better outcomes”
This was especially true if nurses started working with lung cancer patients as soon as they were diagnosed.
While support from advanced nurse practitioners, like lung cancer nurse specialists, has been shown to boost patient satisfaction and the quality of care, the study is one of the first to look at their impact on outcomes for those with cancer including mortality and unplanned admissions.
The researchers looked at more than 108,000 lung cancer diagnoses between 2007 and 2011. They also surveyed more than 200 lung cancer specialist nurses about the working practices at their trusts.
Questions included how confident they felt in challenging any other member of a multi-disciplinary team and the routine interventions provided such as symptom management, holistic needs assessment and health promotion.
The study authors went on to link the data together to create an overall picture of the difference made by specialist nurses to lung cancer patients receiving four types of treatment – surgery, chemotherapy, radiotherapy and no therapy.
While outcomes for patients were not noticeably linked to differences in the working practices or interventions provided by specialist nurses that often, the researchers did observe some “important relationships”.
“Practices were associated with at least one positive outcome within each treatment pathway, most notably for those receiving radiotherapy or not receiving anti-cancer therapy,” said the study authors.
“It is essential that workforces are empowered to deliver the best care”
Key findings included the fact that patients receiving radiotherapy and chemotherapy had a lower risk of early death or emergency admission when they had been assessed and were getting care from a lung cancer nurse specialist – especially if contact began at the time of diagnosis.
The analysis showed radiotherapy patients who were assessed by a specialist nurse were 17% less likely to die in the first year than those not seen by a lung cancer nurse specialist.
Meanwhile, the mortality risk for chemotherapy patients fell when nurses reported feeling confident working within a multi-disciplinary team.
One strong message to come out of the study was the importance of timing when it came to initial assessment by a nurse.
Early assessment by lung cancer specialist nurses was linked to a lower risk of emergency cancer admissions for surgical patients.
For those not receiving anti-cancer therapy, such as those getting palliative care, early assessment was also associated with a lower risk of an emergency cancer admission and unplanned admissions for respiratory complications.
Those not receiving therapy were also less like to be rushed to hospital due to their cancer when specialist nurses provided proactive management of symptoms, found the researchers.
“This work demonstrates that lung cancer nurse specialists are pivotal in the care for patients2
They suggested their findings were significant given current shortages of specialist nurses working in cancer and hoped they would provide “valuable intelligence” to inform workforce policy linked to the government’s cancer strategy.
Iain Stewart, assistant professor of medical statistics at the University of Nottingham, said the research showed “timely nurse involvement and effective multidisciplinary team working can lead to a quantifiably better life with cancer”.
“It is essential that workforces are empowered to deliver the best care,” he added.
Professor Alison Leary, chair of healthcare workforce modelling at London South Bank, said the research showed “the real tangible benefit of advanced practice nursing in cancer”.
“It is clear that receiving care from a lung nurse specialist is fundamental to better outcomes for patients and families,” she added.
“Patients with lung cancer nurse specialists not only had a lower risk of dying, but also had a lower risk of being admitted to hospital unnecessarily,” said Professor Leary.
Vanessa Beattie, chair of the National Lung Cancer Forum for Nurses, said the research demonstrated the key role played by lung cancer nurse specialists.
“This work demonstrates that lung cancer nurse specialists are pivotal in the care for patients and are at the frontline of cancer care,” she said.
She added: “An increase in the lung cancer nurse specialist workforce is required in order to continue to deliver the high quality care, which is reflected in this work.”
The researchers presented their findings in the form of a poster at the National Cancer Registration and Analysis Services conference last month. The study was funded by the Dimbleby Cancer Centre.