Background Lung cancer survival rates in the UK are among the lowest in Europe, principally due to late-stage diagnosis. Alternative routes to earlier diagnosis of lung cancer are needed in socioeconomically deprived communities that are disproportionately affected by poor lung cancer outcomes. We assessed the feasibility and acceptability of a community-based pharmacy referral service to encourage earlier symptomatic referral for chest X-rays. Methods Seventeen community pharmacies located in a deprived area of Wales participated between March 2019 and March 2020. Stakeholder interviews were conducted with four patients, seven pharmacy professionals and one general practitioner. Four focus groups were conducted, including one with healthcare professionals (n=6) and three with members of the public who were current and former smokers (n=13). Quantitative data regarding patient characteristics and clinical outcomes were collected from hospital records and patient referral questionnaires completed by pharmacists and analysed using descriptive statistics. Qualitative data sets were analysed thematically and triangulated. Results Twelve patients used the pharmacy referral service, all of whom were male. Average length of the pharmacy consultation was 13 min, with a mean 3 days to accessing chest X-rays in secondary care. Patients experienced a mean 46-day wait for results, with no lung cancer detected. Participants found the service to be acceptable and considered the pharmacy element to be broadly feasible. Perceived barriers included low awareness of the service and concerns about the role and capacity of pharmacists to deliver the service. Facilitators included perceived approachability and accessibility of pharmacists. A well-publicised, multifaceted awareness campaign was recommended. Conclusions A community pharmacy referral service for lung symptoms was considered an acceptable alternative pathway to symptomatic diagnosis of lung cancer in deprived communities. Wider implementation of the service would require workforce capacity and training to be addressed to ensure optimum utilisation and promotion of the service. Data are available upon reasonable request. De-identified participant data are held by the Research and Development Department, Hywel Dda University Health Board (HDd.Research-Development@wales.nhs.uk). Data and additional information requests will be reviewed case by case by the CI and research team.

中文翻译：

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社区药房转诊服务疑似肺癌症状的可行性和可接受性

背景 英国的肺癌生存率是欧洲最低的，这主要是由于晚期诊断所致。在社会经济贫困的社区中，由于肺癌结果不佳，这些社区需要早期诊断肺癌的替代途径。我们评估了基于社区的药房转诊服务的可行性和可接受性，以鼓励早期有症状转诊进行胸部 X 光检查。方法 2019 年 3 月至 2020 年 3 月期间，位于威尔士贫困地区的 17 家社区药房参与了研究。对 4 名患者、7 名药学专业人员和 1 名全科医生进行了利益相关者访谈。进行了四个焦点小组，其中一个由医疗保健专业人员组成（n = 6），三个由当前和曾经吸烟的公众组成（n = 13）。有关患者特征和临床结果的定量数据是从医院记录和药剂师填写的患者转诊调查问卷中收集的，并使用描述性统计进行分析。对定性数据集进行了主题分析和三角测量。结果 12 名患者使用了药房转诊服务，全部为男性。药房咨询的平均时间为 13 分钟，在二级护理中平均需要 3 天进行胸部 X 光检查。患者等待结果平均需要 46 天，但没有检测出肺癌。参与者认为该服务可以接受，并认为药房元素大致可行。感知到的障碍包括对服务的认识较低以及对药剂师提供服务的作用和能力的担忧。促进因素包括药剂师的感知平易近人性和可及性。建议开展广泛宣传、多方面的宣传活动。结论 针对肺部症状的社区药房转诊服务被认为是贫困社区肺癌症状诊断的可接受的替代途径。更广泛地实施该服务需要解决劳动力能力和培训问题，以确保该服务的最佳利用和推广。数据可根据合理要求提供。去识别化的参与者数据由 Hywel Dda 大学健康委员会研究与开发部 (HDd.Research-Development@wales.nhs.uk) 保存。CI 和研究团队将逐案审查数据和附加信息请求。