146 A cluster randomised feasibility trial (cRCT) to test the routine use of the needs assessment tool: cancer (NAT:C) in primary care to reduce unmet patient and carer needs and determine the feasibility of a definitive trial

Background People with cancer commonly have distressing symptoms and unidentified palliative care needs. The Needs Assessment Tool:Cancer (NAT:-C) is a validated tool to improve needs-based access to palliative care. Aims To assess the feasibility and acceptability of conducting a definitive cRCT of the NAT:-C in primary care in terms of Recruiting 4 GP practices and 40–60 patients (plus carers), Uptake of NAT:-C, Questionnaire completion rates, Acceptability of study measures. Methods A non-blinded cluster randomised trial with parallel process evaluation. Patients with active cancer were identified through cancer registries or in clinic and invited to participate and nominate a carer if they wanted to. Participants completed study questionnaires at baseline and 1, 3 and 6 months. Patients sought a 20 min appointment post-baseline. Patients, carers and GP practice staff were invited to participate in interviews/focus groups. Results Five GP practices were approached and 4 recruited and trained in the use of the NAT:-C. Practices were cluster randomised (1:1). Forty-seven patients and 17 carers were recruited. Early recruitment problems were addressed by including a pre-paid expression of interest form with the study invitation. Recruitment rate was appropriate for a definitive multicentre trial. 44 (94%) of patients received a study appointment, 42 (95%) attended and 32 (76%) received a NAT-guided consultation. Item completion rates of the proposed primary outcome measure the Supportive Care Needs Survey at baseline were 96.4%. 15 patient interviews and 4 focus groups with GP practices were conducted. Participants supported the need for a definitive study and found all measures acceptable. Process evaluation informed effective refinement of study invitations. Conclusion The feasibility trial indicated that the recruitment rate, intervention uptake and data collection were appropriate, with refinements, for a definitive cRCT is feasible.