Leading Edge 2020 Issue 1

www.alphalabs.co.uk 5 Printed on Recycled Paper One of the challenges in clinical diagnostics is the logistics of getting a quality sample from the patient to the laboratory for analysis, to minimise pre-analytical variation. Fortunately, the introduction of FIT has vastly improved the method for faecal sample collection. This is an important aspect of the process since the clinical outcomes are dependent on the ability of the assay to detect faecal haemoglobin at very low, versus undetectable concentrations. Based on extensive experience in delivering services for both screening and symptomatic programmes, Alpha Laboratories’ expertise can help support the logistics for providing FIT testing. Find out more at: faecal-immunochemical-test.co.uk However, patients must be clearly instructed on how to collect the stool, and how to sample it with the test device, in order to minimise any pre-analytical variability. There is also the element of the “unpleasant sample”: many patients would often prefer a blood test to a stool test simply because of the nature of the sample and how to collect it. For these reasons, the bespoke IFU was created to help people participate and encourage those who were unsure, to ask for help. The main purpose of the IFU is to; ■ Improve patient acceptance and uptake by using familiar terminology ■ Improve sampling compliance, by combining graphics and text for clarity, to reduce pre-analytical variation ■ Standardise the service to aid data collection and analysis Patient Feedback To help assess the effectiveness of the IFU, plus the patients understanding and receptiveness of the test, a short questionnaire card was also included in the patient pack. This survey method allowed patients to provide their feedback on the service, to help the SWCA ensure they are offering the best service for patients. The questionnaires focused on how userfriendly the test was, and what the patient thought of the end-to-end process. 95% of patients understood their instruction leaflet. 96% knew what to do with their sample once completed. H g Name Date of Sample 999XXX 80101274 2099.12.31 M / F Amy Sample 95% of patients understood their instruction leaflet 96% of patients knew what to do with their sample once completed 92% reported that their GP explained the purpose of the test. This excellent response highlights that most patients found the instructions clear and were able to return the samples without issue. The SWCA also reports that the return rate of the questionnaire card was high; almost all patients who submitted a FIT sample, also included their completed questionnaire card. Primary Care Engagement To further support the service, when it was launched in 2018, Primary Care Engagement events were held. Printed guides were developed for the GPs to aid their decisionmaking process and help them understand the role of FIT in the referral pathway. Patients were also questioned on how well they felt the GP was able to help them; was the test explained, and was the onward pathway outlined to them? 92% of patients reported that their GP explained the purpose of the test. The feedback directly from primary care is also positive. With all surgeries now fully participating in the FIT referral service, it is hoped that this will continue to support the CRC pathway to ensure more cancers are found earlier. This support from primary care is vital to the success of the service. A structured service with engagement from all stakeholders is key to bringing down costs and ensuring effective use of the test – ultimately working to improve the patient experience and outcomes.