People with lung cancer face significant unmet needs, impacting experiences and outcomes of care, and service costs. A value-based healthcare approach, seeking to optimise outcomes relative to healthcare expenditure, may help tailor service provision and improve efficiency. However, value-based approaches often specify clinical outcomes as target measures not always reflective of patient preferences. A bottom-up approach (where patients specify outcomes) promotes person-centred care, a central component of value-based care. This qualitative study illustrates this approach by exploring components of supportive care valued by people with lung cancer. We aimed to understand participants’ supportive care needs, valued components of care effective in addressing needs, and the impact of service provision.
Participants comprised people with lung cancer attending two public, metropolitan health services. Purposive sampling was employed to include demographically diverse individuals. Qualitative semi-structured interviews were used to explore participant experiences of supportive care need, services received and valued, and outcomes of support received. Qualitative data were analysed thematically using interpretive description.
Twenty-three people with lung cancer participated. Demographic and clinical data were analysed descriptively. Qualitative analysis revealed three themes: valued components of supportive care (sub-themes: ongoing opportunity for consultation and person-centred information), benefits of valued supportive care, and consequences of missed supportive care. Importantly, patients described absence of or generic approaches to supportive care as factors that led to disengagement from, loss of trust in, and feelings of not being valued by the healthcare system.
People with lung cancer valued ongoing opportunities for consultation and person-centred information, tailored to their supportive care needs. This study contributes new knowledge, describing what components of supportive care people with lung cancer value, highlighting opportunities to strengthen value-based lung cancer care. A bottom-up approach provides opportunity to establish models of care informed by outcomes that matter to patients.