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Patient experience and satisfaction with symptomatic Faecal Immunochemical Testing: An explanatory sequential mixed-methods evaluation

Background: Recent evidence suggests that faecal immunochemical testing (FIT) can rule out colorectal cancer in symptomatic adults. To date, there is little research exploring experiences of FIT for this population. Aim: To explore patient experience and satisfaction with FIT in an ‘early adopter’ site in England. Design: We used an explanatory sequential mixed-methods approach combining mailed quantitative surveys with semi-structured telephone interviews. Methods: Multivariate logistic regression was used to analyse quantitative data. Thematic analysis was used to assess qualitative transcripts. Results: The survey had 260 respondents and found satisfaction with FIT was high (88.7%). Compared with test satisfaction, the proportion of respondents satisfied with GP consultation, and how they received their results, was lower (74.4% and 76.2%, respectively). Multivariate analysis showed increased area-level deprivation and not receiving an explanation of the purpose of the test were associated with lower satisfaction with GP consultation (both P-values<0.05), while increased area-level deprivation and not receiving results from the GP were associated with lower satisfaction with receiving results (both P-values<0.05). Interviews with respondents (n=20) helped explain the quantitative results. They revealed that “not knowing the purpose of the test” caused “anxiety” and “confusion”, which led to dissatisfaction. “Not receiving results from GP” was considered “unacceptable”, as this left patients with a “niggling doubt” and lack of diagnosis, or assurance that they did not have cancer. Conclusion: Patient satisfaction with symptomatic FIT is high. Efforts to improve satisfaction should focus on ensuring patients understand the purpose of the test and always receive their test results.