@article { , title = {Promoting help-seeking in response to symptoms amongst primary care patients at high risk of lung cancer: a mixed method study}, abstract = {Background: Lung cancer symptoms are vague and difficult to detect. Interventions are needed to promote early diagnosis, however health services are already pressurised. This study explored symptomology and help-seeking behaviours of primary care patients at ‘high-risk’ of lung cancer (≥50 years old, recent smoking history), to inform targeted interventions. Methods: Mixed method study with patients at eight general practitioner (GP) practices across south England. Study incorporated: postal symptom questionnaire; clinical records review of participant consultation behaviour 12 months pre- and post-questionnaire; qualitative participant interviews (n = 38) with a purposive sample. Results: A small, clinically relevant group (n = 61/908, 6.7\%) of primary care patients was identified who, despite reporting potential symptoms of lung cancer in questionnaires, had not consulted a GP ≥12 months. Of nine symptoms associated with lung cancer, 53.4\% (629/1172) of total respondents reported ≥1, and 35\% (411/1172) reported ≥2. Most participants (77.3\%, n = 686/908) had comorbid conditions; 47.8\%, (n = 414/908) associated with chest and respiratory symptoms. Participant consulting behaviour significantly increased in the 3-month period following questionnaire completion compared with the previous 3-month period (p = .002), indicating questionnaires impacted upon consulting behaviour. Symptomatic non-consulters were predominantly younger, employed, with higher multiple deprivation scores than their GP practice mean. Of symptomatic non-consulters, 30\% (18/61) consulted ≤1 month post-questionnaire, with comorbidities subsequently diagnosed for five participants. Interviews (n = 39) indicated three overarching differences between the views of consulting and non-consulting participants: concern over wasting their own as well as GP time; high tolerance threshold for symptoms; a greater tendency to self-manage symptoms. Conclusions: This first study to examine symptoms and consulting behaviour amongst a primary care population at ‘high- risk’ of lung cancer, found symptomatic patients who rarely consult GPs, might respond to a targeted symptom elicitation intervention. Such GP-based interventions may promote early diagnosis of lung cancer or other comorbidities, without burdening already pressurised services.}, doi = {10.1371/journal.pone.0165677}, eissn = {1932-6203}, issue = {11}, journal = {PLoS ONE}, note = {Open Acces article. OL 09.02.2017}, pages = {1-20}, publicationstatus = {Published}, publisher = {Public Library of Science}, url = {https://nottingham-repository.worktribe.com/output/830058}, volume = {11}, year = {2016}, author = {Wagland, Richard and Brindle, Lucy and Ewings, Sean and James, Elizabeth and Moore, Mike and Rivas, Carol and Esqueda, Ana Ibanez and Corner, Jessica} }