Facilitators and barriers to early diagnosis of pleural mesothelioma: A qualitative study of patients' experiences towards getting a diagnosis.

PURPOSE

Prognosis with pleural mesothelioma (PM) is poor, yet evidence indicates a better chance of survival and quality of life if diagnosed earlier. There has been little attention to PM patients' experiences prior to diagnosis as available studies have focused on their lived experiences after diagnosis. This study aims to qualitatively explore and identify the barriers and facilitators to PM diagnosis and looks to understand the reasons for any variability in patients' experiences along their diagnosis journey and proposed treatment plans.

METHODS

Seventeen participants with confirmed PM diagnosis took part in in-depth, semi-structured interviews about their journey to diagnosis. Participants were purposively recruited from two specialist PM outpatient clinics in England. The interview data were analysed using framework analysis underpinned by the Model of Pathway to treatment.

RESULTS

Our findings identified 15 different barriers and facilitators across the four intervals within the model. Within the appraisal and diagnostic intervals, the presentation of vague symptoms that were mistaken for a less serious illness were a considerable barrier. Health literacy regarding PM had an impact on how soon a patient sought help regarding their symptoms and how quickly they were placed on a PM diagnostic pathway by the healthcare professionals (HCP), and this was impacted the HCP's knowledge of PM.

CONCLUSION

Earlier symptom recognition by both patient and those in initial contact such as General practitioners (GPs) and other HCPs, can be used to target significant and avoidable delays along the pathway, thereby promoting earlier diagnosis and treatment options.