Promoting integrated care in prostate cancer through online prostate cancer-specific holistic needs assessment: a feasibility study in primary care

Abstract

Purpose This study assessed the feasibility of implementing a novel model of integrated prostate cancer care involving an online prostate cancer-specific holistic needs assessment (sHNA) and shared digital communication between patients and their healthcare professionals (HCPs). The sHNA produces a semi-automated care plan that is finalised in consultation between the patient and their practice nurse. Methods Men living with and beyond prostate cancer were invited to participate in a 9-month non-randomised cluster controlled feasibility study. The intervention group was asked to complete the sHNA on three occasions. Data were collected using Patient Reported Outcome Measures (PROMs) at baseline, 10 and 24 weeks, and 9 months. Outcomes included recruitment, retention, acceptability, and engagement with the sHNA and PROMs. Results Fourteen general practices (8 intervention and 6 control), and 41 men (29 intervention and 12 control) participated. Initial patient engagement with the sHNA was high, with all but one receiving practice nurse-led follow-up and an individualised care plan. The sHNA proved useful in identifying 'red flag' symptoms, and helping practice nurses decide when to seek further medical care for the patients. There was a high level of acceptability for patients and HCPs. However, integration of care did not occur as intended because of problems linking hospital and general practice IT systems. Conclusion While the study demonstrated the feasibility of implementing the sHNA, it did not meet the a priori progression criteria; as such, undertaking a definitive randomised controlled trial is not appropriate until the identified methodological and technical issues have been addressed.

Role of the nurse in the design, delivery, monitoring and coordination of cancer survivorship care plans: An integrative review

“…Nineteen of the 22 articles noted that all SCPs begin with the design of the plan and the selection of the content that will be included (Clarke et al, 2020;Coyle et al, 2014;de Rooij et al, 2017de Rooij et al, , 2019DeGuzman et al, 2014;Ezendam et al, 2014;Miller, 2008;Glaser et al, 2019;Hawkins-Taylor et al, 2019;Jefford et al, 2013;Jeppesen et al, 2018;Mayer et al, ,2014Mayer et al, , , 2016Nicolaije et al, ,2013Nicolaije et al, , , 2015Nolte et al, 2016;Reb et al, 2017;Singh-Carlson et al, 2018;Sprague et al, 2013).…”

“…The included studies indicated that each health centre chose and developed its own specific SCP based on the different models proposed by the main scientific societies mentioned above (Brant et al, 2016;Clarke et al, 2020;Coyle et al, 2014;Miller, 2008;Glaser et al, 2019;Hawkins-Taylor et al, 2019;Jefford et al, 2013;Reb et al, 2017;Singh-Carlson et al, 2018). Despite the heterogeneity of the SCPs, all of them were based on proposals designed from the IOM report.…”

A Qualitative Exploration of Prostate Cancer Survivors Experiencing Psychological Distress: Loss of Self, Function, Connection, and Control

“…Data reported here came from a subsample (n=28) of this larger interview dataset comprising all men who were identified as having psychological distress on one or both of the following validated measures of psychological distress from the LAPCD survey: the Short Warwick-Edinburgh Mental-Well-being Scale (SWEMWBS) (Stewart-Brown et al, 2009), and the six item version of the Kessler Psychological Distress Scale (K6) (Kessler et al, 2002). The SWEMWBS (Stewart-Brown et al, 2009) aims to measure psychological well-being, and the full version has been widely used in national surveys (National Statistics, 2017) and in cancer research (Clarke et al, 2019). Scores ≤19.25 are suggested to indicate poor well-being (Ng, Kristjanson, & Medigovich, 2006).…”

The potential of peer support to extend the reach of digital health

“…To address the issue of access to digital health among older people and other underrepresented groups, we have been piloting a support role for peers that makes use of their skills, experience and empathy within the context of a research study. In designing our primary care-based feasibility study of an online cancer specific holistic needs assessment (csHNA) in prostate cancer (Integrated Care in Prostate Cancer, ICARE-P) 20,21,22 we were conscious of the need to encourage older men to take part and use the online system. To meet this need we developed the concept of an ITmate: a peer supporter with personal experience of prostate cancer who had sufficient confidence in using IT to allow him to assist others in taking part in the intervention.…”