Study title

PLUS study - Pharmacy referral for Lung cancer Symptoms: A feasibility study to assess the role of pharmacists in lung cancer diagnosis compared to current pathways

Principal / Lead Investigator

Dr Gareth Collier & Rachel Gemine (Hywel Dda UHB)

  • Prof Kate Brain (PRIME/WCRC, Cardiff University)
  • Dr Grace McCutchan (Research Associate, Cardiff University)
  • Dr Harriet Quinn-Scoggins (Research Associate, Cardiff University)
  • Lucy Hill (Researcher, Hywel Dda UHB)
  • Dr Mark Andrews (Consultant, Hywel Dda UHB)
  • Dr Robbie Ghosal (Consultant, Hywel Dda UHB)
Type of study


Study sponsor

Hywel Dda University Health Board


Lung cancer is the leading cause of cancer death in the UK with over 30,000 per year and although there have been major developments in surgery, radiotherapy and chemotherapy, there has been very little improvement in survival over the last 20 years with over 85% of people dying within one year of diagnosis. This is due to patients being diagnosed at a late stage when the cancer has grown and spread meaning that the patient is no longer able to have treatment that may provide a cure.

Research indicated that delayed diagnosis is largely due to delays in patients attending their GP with symptoms of lung cancer. This is mainly due to a lack of symptom awareness and a reluctance to seek medical attention. This may be because patients are concerned that they would be wasting the GP’s time and are worried about what the GP might discover. In addition patients from Wales have the lowest awareness of symptoms compared to the rest of the UK and Europe.

Pharmacy interventions have shown to be highly effective within diabetes and smoking cessation. We propose that pharmacists referral for chest x-ray in patients with symptoms of possible lung cancer will encourage patients to seek medical attention sooner and lead to more patients being diagnosed at an earlier stage. Within this study we recruit patients to be screened by pharmacists and referred for chest x-ray if needed. They will be followed up and the outcome of their diagnosis recorded. Patients will be asked to complete a questionnaire to give feedback of the process and a sub-set will be invited to interview.

Public / patient involvement

The development of this study has resulted from feedback of patients with LC in a research development meeting and has been discussed with patients attended the LC survivorship group who have offered support and highlighted the benefit of this proposed service. To ensure that patients continue to be involved in the design of the study, we have formed an advisory/steering group, with two patient representatives. They will be essential to the development and conduct of the study. We will have a maximum of six study steering group meetings. This study has been designed to explicitly engage patients and the public in implementation and evaluation. Results will explore and highlight patient views and experiences and ensure that these are taken in to consideration when taking the research forward.

How could this research potentially benefit patients?

The results of this research will help us to understand what services we can develop to make the most difference to lung cancer patients. This will help patients get the most appropriate treatment for symptoms and will add to an area of research that is improving earlier diagnosis.


Health and Care Research Wales

Total grant value

£ 299,000

Start date


End date


Further information

To follow

Outputs generated (Reports / Publications / Impact)

To follow