EP.TH.602Exploring decision-making of healthcare professionals in patients with benign large non-pedunculated colonic polyps (BLNPCP) virtually using combined focus group and nominal group technique

Abstract Aim We aimed to elicit key factors that influence healthcare professional decision-making when deciding treatment for BLNPCP. Background Benign large non-pedunculated colonic polyps (BLNPCP) may harbour covert malignancy and opinions differ about the optimal modality. There are several options available, including endoscopic mucosal resection, submucosal combined laparoscopic surgery surgical resection. Despite widespread availability of resection techniques, there high rates in UK. Methods Three focus groups professionals, comprised either consultant colorectal surgeons, nurse endoscopists gastroenterologists, were conducted virtually utilising Nominal Group Technique. Meetings recorded transcribed verbatim. Themes devolved using framework approach qualitative analysis. A priority-ranked list influencing this setting was generated. Results Five main themes identified as decision-making: Shared decision making (patient preference, informed consent); Patient (co-morbidity, age, life-expectancy); Polyp (Location, size, morphology, risk cancer); Healthcare professionals (skill-set, personal preference); System (techniques locally, regional referral networks). Technique generated 55 items across three groups. Nurses gastroentologists ranked patient (particularly drug history tolerance procedure) shared preference) more highly then surgeons. Surgeons placed greater emphasis on polyp particularly location invasive carcinoma. Conclusion Decision is complex multifactorial. These results support benefits MDTs involvement decision-making. The complexity underpin wide variation practice.