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Published in: Supportive Care in Cancer 4/2020

Open Access 01-04-2020 | Prostate Cancer | Original Article

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

Authors: Amy L. Clarke, Julia Roscoe, Rebecca Appleton, Deepak Parashar, Radha Muthuswamy, Omar Khan, Jeremy Dale, Veronica Nanton

Published in: Supportive Care in Cancer | Issue 4/2020

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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.
Literature
2.
go back to reference Watson E, Shinkins B, Frith E, Neal D, Hamdy F, Walter F, Weller D, Wilkinson C, Faithfull S, Wolstenholme J (2016) Symptoms, unmet needs, psychological well-being and health status in survivors of prostate cancer: implications for redesigning follow-up. BJU Int 117(6B):E10–E19CrossRef Watson E, Shinkins B, Frith E, Neal D, Hamdy F, Walter F, Weller D, Wilkinson C, Faithfull S, Wolstenholme J (2016) Symptoms, unmet needs, psychological well-being and health status in survivors of prostate cancer: implications for redesigning follow-up. BJU Int 117(6B):E10–E19CrossRef
3.
go back to reference Hansen DG, Larsen PV, Holm LV, Rottmann N, Bergholdt SH, Søndergaard J (2013) Association between unmet needs and quality of life of cancer patients: a population-based study. Acta Oncol 52(2):391–399CrossRef Hansen DG, Larsen PV, Holm LV, Rottmann N, Bergholdt SH, Søndergaard J (2013) Association between unmet needs and quality of life of cancer patients: a population-based study. Acta Oncol 52(2):391–399CrossRef
4.
go back to reference Mazza D, Mitchell G (2017) Cancer, ageing, multimorbidity and primary care. Eur J Cancer Care 26(3):e12717CrossRef Mazza D, Mitchell G (2017) Cancer, ageing, multimorbidity and primary care. Eur J Cancer Care 26(3):e12717CrossRef
5.
go back to reference NICE National Institute for Health and Care Excellence (2014) Prostate cancer: diagnosis and management. Clinical guideline [CG175]. Accessed 11 February 2019 NICE National Institute for Health and Care Excellence (2014) Prostate cancer: diagnosis and management. Clinical guideline [CG175]. Accessed 11 February 2019
6.
go back to reference Cortis L, Ward P, McKinnon R, Koczwara B (2017) Integrated care in cancer: what is it, how is it used and where are the gaps? A textual narrative literature synthesis. Eur J Cancer Care 26(4):e12689CrossRef Cortis L, Ward P, McKinnon R, Koczwara B (2017) Integrated care in cancer: what is it, how is it used and where are the gaps? A textual narrative literature synthesis. Eur J Cancer Care 26(4):e12689CrossRef
7.
go back to reference European CanCer Organisation (2017) Intergrated Cancer Care: Bringing Primary Care and Secondary Care Together EECO Position Statement. Accessed 11 Feb 2019 European CanCer Organisation (2017) Intergrated Cancer Care: Bringing Primary Care and Secondary Care Together EECO Position Statement. Accessed 11 Feb 2019
8.
go back to reference Lawn S, Fallon-Ferguson J, Koczwara B (2017) Shared care involving cancer specialists and primary care providers–what do cancer survivors want? Health Expect 20(5):1081–1087CrossRef Lawn S, Fallon-Ferguson J, Koczwara B (2017) Shared care involving cancer specialists and primary care providers–what do cancer survivors want? Health Expect 20(5):1081–1087CrossRef
9.
go back to reference Garg S, Williams NL, Ip A, Dicker AP (2018) Clinical integration of digital solutions in health care: an overview of the current landscape of digital technologies in cancer care. JCO Clin Cancer Inform (2):1–9 Garg S, Williams NL, Ip A, Dicker AP (2018) Clinical integration of digital solutions in health care: an overview of the current landscape of digital technologies in cancer care. JCO Clin Cancer Inform (2):1–9
10.
go back to reference Nanton V, Appleton R, Dale J, Roscoe J, Hamborg T, Ahmedzai SH, Arvanitis TN, Badger D, James N, Mendelsohn R (2017) Integrated Care in Prostate Cancer (ICARE-P): nonrandomized controlled feasibility study of online holistic needs assessment, linking the patient and the health care team. JMIR Res Protoc 6(7):e147 CrossRef Nanton V, Appleton R, Dale J, Roscoe J, Hamborg T, Ahmedzai SH, Arvanitis TN, Badger D, James N, Mendelsohn R (2017) Integrated Care in Prostate Cancer (ICARE-P): nonrandomized controlled feasibility study of online holistic needs assessment, linking the patient and the health care team. JMIR Res Protoc 6(7):e147 CrossRef
11.
go back to reference Bowen DJ, Kreuter M, Spring B, Cofta-Woerpel L, Linnan L, Weiner D, Bakken S, Kaplan CP, Squiers L, Fabrizio C (2009) How we design feasibility studies. Am J Prev Med 36(5):452–457CrossRef Bowen DJ, Kreuter M, Spring B, Cofta-Woerpel L, Linnan L, Weiner D, Bakken S, Kaplan CP, Squiers L, Fabrizio C (2009) How we design feasibility studies. Am J Prev Med 36(5):452–457CrossRef
12.
go back to reference Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, Bonsel G, Badia X (2011) Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 20(10):1727–1736CrossRef Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, Bonsel G, Badia X (2011) Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 20(10):1727–1736CrossRef
13.
go back to reference Groenvold M, Klee MC, Sprangers MA, Aaronson NK (1997) Validation of the EORTC QLQ-C30 quality of life questionnaire through combined qualitative and quantitative assessment of patient-observer agreement. J Clin Epidemiol 50(4):441–450CrossRef Groenvold M, Klee MC, Sprangers MA, Aaronson NK (1997) Validation of the EORTC QLQ-C30 quality of life questionnaire through combined qualitative and quantitative assessment of patient-observer agreement. J Clin Epidemiol 50(4):441–450CrossRef
14.
go back to reference Hodgkinson K, Butow P, Hunt G, Pendlebury S, Hobbs K, Lo SK, Wain G (2007) The development and evaluation of a measure to assess cancer survivors' unmet supportive care needs: the CaSUN (Cancer Survivors’ unmet needs measure). Psycho-Oncology 16(9):796–804CrossRef Hodgkinson K, Butow P, Hunt G, Pendlebury S, Hobbs K, Lo SK, Wain G (2007) The development and evaluation of a measure to assess cancer survivors' unmet supportive care needs: the CaSUN (Cancer Survivors’ unmet needs measure). Psycho-Oncology 16(9):796–804CrossRef
15.
go back to reference Tennant R, Hiller L, Fishwick R, Platt S, Joseph S, Weich S, Parkinson J, Secker J, Stewart-Brown S (2007) The Warwick-Edinburgh mental well-being scale (WEMWBS): development and UK validation. Health Qual Life Outcomes 5(1):63CrossRef Tennant R, Hiller L, Fishwick R, Platt S, Joseph S, Weich S, Parkinson J, Secker J, Stewart-Brown S (2007) The Warwick-Edinburgh mental well-being scale (WEMWBS): development and UK validation. Health Qual Life Outcomes 5(1):63CrossRef
16.
go back to reference Hibbard JH, Stockard J, Mahoney ER, Tusler M (2004) Development of the patient activation measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res 39(4p1):1005–1026CrossRef Hibbard JH, Stockard J, Mahoney ER, Tusler M (2004) Development of the patient activation measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res 39(4p1):1005–1026CrossRef
17.
go back to reference Jones D, Dunn L, Watt I, Macleod U (2019) Safety netting for primary care: evidence from a literature review. Br J Gen Pract 69(678):e70–e79CrossRef Jones D, Dunn L, Watt I, Macleod U (2019) Safety netting for primary care: evidence from a literature review. Br J Gen Pract 69(678):e70–e79CrossRef
18.
go back to reference Crawford-Williams F, March S, Goodwin BC, Ralph N, Galvao DA, Newton RU, Chambers SK, Dunn J (2018) Interventions for prostate cancer survivorship: a systematic review of reviews. Psycho-Oncology 27(10):2339–2348CrossRef Crawford-Williams F, March S, Goodwin BC, Ralph N, Galvao DA, Newton RU, Chambers SK, Dunn J (2018) Interventions for prostate cancer survivorship: a systematic review of reviews. Psycho-Oncology 27(10):2339–2348CrossRef
19.
go back to reference Ford JG, Howerton MW, Lai GY, Gary TL, Bolen S, Gibbons MC, Tilburt J, Baffi C, Tanpitukpongse TP, Wilson RF (2008) Barriers to recruiting underrepresented populations to cancer clinical trials: a systematic review. Cancer 112(2):228–242CrossRef Ford JG, Howerton MW, Lai GY, Gary TL, Bolen S, Gibbons MC, Tilburt J, Baffi C, Tanpitukpongse TP, Wilson RF (2008) Barriers to recruiting underrepresented populations to cancer clinical trials: a systematic review. Cancer 112(2):228–242CrossRef
20.
go back to reference Watson EK, Shinkins B, Matheson L, Burns RM, Frith E, Neal D, Hamdy F, Walter FM, Weller D, Wilkinson C (2018) Supporting prostate cancer survivors in primary care: findings from a pilot trial of a nurse-led psycho-educational intervention (PROSPECTIV). Eur J Oncol Nurs 32:73–81CrossRef Watson EK, Shinkins B, Matheson L, Burns RM, Frith E, Neal D, Hamdy F, Walter FM, Weller D, Wilkinson C (2018) Supporting prostate cancer survivors in primary care: findings from a pilot trial of a nurse-led psycho-educational intervention (PROSPECTIV). Eur J Oncol Nurs 32:73–81CrossRef
21.
go back to reference Corbett T, Singh K, Payne L, Bradbury K, Foster C, Watson E, Richardson A, Little P, Yardley L (2018) Understanding acceptability of and engagement with web-based interventions aiming to improve quality of life in cancer survivors: a synthesis of current research. Psycho-oncology 27(1):22–33CrossRef Corbett T, Singh K, Payne L, Bradbury K, Foster C, Watson E, Richardson A, Little P, Yardley L (2018) Understanding acceptability of and engagement with web-based interventions aiming to improve quality of life in cancer survivors: a synthesis of current research. Psycho-oncology 27(1):22–33CrossRef
22.
go back to reference Clarke AL, Roscoe J, Appleton R, Dale J, Nanton V (2019 Dec) “My gut feeling is we could do more...” a qualitative study exploring staff and patient perspectives before and after the implementation of an online prostate cancer-specific holistic needs assessment. BMC Health Serv Res 19(1):115CrossRef Clarke AL, Roscoe J, Appleton R, Dale J, Nanton V (2019 Dec) “My gut feeling is we could do more...” a qualitative study exploring staff and patient perspectives before and after the implementation of an online prostate cancer-specific holistic needs assessment. BMC Health Serv Res 19(1):115CrossRef
23.
go back to reference Casey R, Powell L, Braithwaite M, Booth C, Sizer B, Corr J (2017) Nurse-led phone call follow-up clinics are effective for patients with prostate cancer. JPE 4(3):114–120PubMed Casey R, Powell L, Braithwaite M, Booth C, Sizer B, Corr J (2017) Nurse-led phone call follow-up clinics are effective for patients with prostate cancer. JPE 4(3):114–120PubMed
24.
go back to reference Murray E, Hekler EB, Andersson G, Collins LM, Doherty A, Hollis C, Rivera DE, West R, Wyatt JC (2016) Evaluating digital health interventions: key questions and approaches. Am J Prev Med 51(5):843–851CrossRef Murray E, Hekler EB, Andersson G, Collins LM, Doherty A, Hollis C, Rivera DE, West R, Wyatt JC (2016) Evaluating digital health interventions: key questions and approaches. Am J Prev Med 51(5):843–851CrossRef
25.
go back to reference Wagner EH, Ludman EJ, Bowles EJA, Penfold R, Reid RJ, Rutter CM, Chubak J, McCorkle R (2014) Nurse navigators in early cancer care: a randomized, controlled trial. J Clin Oncol 32(1):12–18CrossRef Wagner EH, Ludman EJ, Bowles EJA, Penfold R, Reid RJ, Rutter CM, Chubak J, McCorkle R (2014) Nurse navigators in early cancer care: a randomized, controlled trial. J Clin Oncol 32(1):12–18CrossRef
26.
go back to reference Rice SM, Oliffe JL, Kelly MT, Cormie P, Chambers S, Ogrodniczuk JS, Kealy D (2018) Depression and prostate cancer: examining comorbidity and male-specific symptoms. Am J Mens Health 12(6):1864–1872CrossRef Rice SM, Oliffe JL, Kelly MT, Cormie P, Chambers S, Ogrodniczuk JS, Kealy D (2018) Depression and prostate cancer: examining comorbidity and male-specific symptoms. Am J Mens Health 12(6):1864–1872CrossRef
28.
go back to reference Nekhlyudov L, Ganz PA, Arora NK, Rowland JH (2017) Going beyond being lost in transition: a decade of progress in cancer survivorship. J Clin Oncol 35 (18):1978CrossRef Nekhlyudov L, Ganz PA, Arora NK, Rowland JH (2017) Going beyond being lost in transition: a decade of progress in cancer survivorship. J Clin Oncol 35 (18):1978CrossRef
Metadata
Title
Promoting integrated care in prostate cancer through online prostate cancer-specific holistic needs assessment: a feasibility study in primary care
Authors
Amy L. Clarke
Julia Roscoe
Rebecca Appleton
Deepak Parashar
Radha Muthuswamy
Omar Khan
Jeremy Dale
Veronica Nanton
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 4/2020
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-019-04967-y

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