The Burden of Barrett's Oesophagus

Abstract

Barrett's oesophagus is a well-established and increasingly common precancerous condition which requires long term endoscopic surveillance. Undoubtedly this may impact patients both physically and psychologically. However, very little is known about the true burden of this condition and its care pathways on patients' quality of life. This thesis presents a body of work, in journal format, which aims to give both an in-depth qualitative account of disease impact and quantitative assessment of the prevalence of these factors. Finally, this thesis identifies broader patient centred research uncertainties, which if investigated will hopefully shift the landscape of research in favour of the patient. The chapters presented in this thesis include an introductory literature review which highlights what is currently known, limitations of research to date, and gaps in knowledge concerning BO health related quality of life. The following two chapters (chapters 2 and 3) adopt a mixed method approach (qualitative and quantitative) to assessing BO health related quality of life. These chapters address the impact of symptoms, worry of oesophageal cancer, anxiety, depression, perceptions of cancer risk, experiences of follow up care and patient views on new follow up systems. Chapter 4 then looks at the broader issues facing patients with BO and GORD by asking what are their key future research priorities. This qualitative and quantitative prioritisation process engages both patients and professionals on a level playing. This process culminates in a modified Delphi process to reach a consensus "top 10 research priorities". Chapter 5 begins to assesses the potential benefits of a dedicated BO surveillance service, a top 10 research priority identified in chapter 4. Finally, a discussion chapter brings together the key findings from all 4 journal articles before outlining future research proposals in abstract format.

Date of Award	1 Aug 2020
Original language	English
Awarding Institution	The University of Manchester
Supervisor	John Mclaughlin (Supervisor), Shaheen Hamdy (Supervisor) & Yeng Ang (Supervisor)