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Follow-up care after treatment for prostate cancer: evaluation of a supported self-management and remote surveillance programme

Follow-up care after treatment for prostate cancer: evaluation of a supported self-management and remote surveillance programme
Follow-up care after treatment for prostate cancer: evaluation of a supported self-management and remote surveillance programme
Background
Alternative models of cancer follow-up care are needed to ameliorate pressure on services and better meet survivors’ long-term needs. This paper reports an evaluation of a service improvement initiative for the follow-up care of prostate cancer patients based on remote monitoring and supported self-management.

Methods
This multi-centred, historically controlled study compared patient reported outcomes of men experiencing the new Programme with men experiencing a traditional clinic appointment model of follow-up care, who were recruited in the period immediately prior to the introduction of the Programme. Data were collected by self-completed questionnaires, with follow up measurement at four and eight months post-baseline. The primary outcome was men’s unmet survivorship needs, measured by the Cancer Survivors’ Unmet Needs Survey. Secondary outcomes included cancer specific quality of life, psychological wellbeing and satisfaction with care. The analysis was intention to treat. Regression analyses were conducted for outcomes at each time point separately, controlling for pre-defined clinical and demographic variables. All outcome analyses are presented in the paper. Costs were compared between the two groups.

Results
Six hundred and twenty-seven men (61%) were consented to take part in the study (293 in the Programme and 334 in the comparator group.) Regarding the primary measure of unmet survivorship needs, 25 of 26 comparisons favoured the Programme, of which 4 were statistically significant. For the secondary measures of activation for self-management, quality of life, psychological well-being and lifestyle, 20 of 32 comparisons favoured the Programme and 3 were statistically significant. There were 22 items on the satisfaction with care questionnaire and 13 were statistically significant. Per participant costs (British pounds, 2015) in the 8 month follow up period were slightly lower in the programme than in the comparator group (£289 versus £327). The Programme was acceptable to patients.

Conclusion
The Programme is shown to be broadly comparable to traditional follow-up care in all respects, adding to evidence of the viability of such models.
1471-2407
1-18
Frankland, Jane
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Brodie, Hazel
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Cooke, Deborah
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Foster, Claire
00786ac1-bd47-4aeb-a0e2-40e058695b73
Gage, Heather
19bfbcaf-5cec-4ca4-8830-53216e56a460
Jordan, Jake
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Mesa-Eguiagaray, Ines
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Pickering, Ruth
4a828314-7ddf-4f96-abed-3407017d4c90
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Frankland, Jane
94f07ae3-6361-4572-b716-6fdc4ba3c75a
Brodie, Hazel
bf47d6a9-8fbe-4a1c-ace5-6487293d8321
Cooke, Deborah
9ab3bbc7-4b07-45f7-b19e-93d053508c5e
Foster, Claire
00786ac1-bd47-4aeb-a0e2-40e058695b73
Gage, Heather
19bfbcaf-5cec-4ca4-8830-53216e56a460
Jordan, Jake
01ac55ca-8542-4e62-ae60-f64a0746c486
Mesa-Eguiagaray, Ines
edbe6ed2-c8a9-4df6-a9ad-15b11ac8d9f7
Pickering, Ruth
4a828314-7ddf-4f96-abed-3407017d4c90
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7

Frankland, Jane, Brodie, Hazel, Cooke, Deborah, Foster, Claire, Gage, Heather, Jordan, Jake, Mesa-Eguiagaray, Ines, Pickering, Ruth and Richardson, Alison (2019) Follow-up care after treatment for prostate cancer: evaluation of a supported self-management and remote surveillance programme. BMC cancer, 19 (368), 1-18. (doi:10.1186/s12885-019-5561-0).

Record type: Article

Abstract

Background
Alternative models of cancer follow-up care are needed to ameliorate pressure on services and better meet survivors’ long-term needs. This paper reports an evaluation of a service improvement initiative for the follow-up care of prostate cancer patients based on remote monitoring and supported self-management.

Methods
This multi-centred, historically controlled study compared patient reported outcomes of men experiencing the new Programme with men experiencing a traditional clinic appointment model of follow-up care, who were recruited in the period immediately prior to the introduction of the Programme. Data were collected by self-completed questionnaires, with follow up measurement at four and eight months post-baseline. The primary outcome was men’s unmet survivorship needs, measured by the Cancer Survivors’ Unmet Needs Survey. Secondary outcomes included cancer specific quality of life, psychological wellbeing and satisfaction with care. The analysis was intention to treat. Regression analyses were conducted for outcomes at each time point separately, controlling for pre-defined clinical and demographic variables. All outcome analyses are presented in the paper. Costs were compared between the two groups.

Results
Six hundred and twenty-seven men (61%) were consented to take part in the study (293 in the Programme and 334 in the comparator group.) Regarding the primary measure of unmet survivorship needs, 25 of 26 comparisons favoured the Programme, of which 4 were statistically significant. For the secondary measures of activation for self-management, quality of life, psychological well-being and lifestyle, 20 of 32 comparisons favoured the Programme and 3 were statistically significant. There were 22 items on the satisfaction with care questionnaire and 13 were statistically significant. Per participant costs (British pounds, 2015) in the 8 month follow up period were slightly lower in the programme than in the comparator group (£289 versus £327). The Programme was acceptable to patients.

Conclusion
The Programme is shown to be broadly comparable to traditional follow-up care in all respects, adding to evidence of the viability of such models.

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Follow-up care after treatment for prostate cancer: evaluation of a supported self-management and remote surveillance programme - Accepted Manuscript
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Accepted/In Press date: 30 March 2019
Published date: 23 April 2019

Identifiers

Local EPrints ID: 429977
URI: https://eprints.soton.ac.uk/id/eprint/429977
ISSN: 1471-2407
PURE UUID: 1fe3c0e5-d4fb-4f6b-9513-76d52fd66a01
ORCID for Jane Frankland: ORCID iD orcid.org/0000-0002-3813-8879
ORCID for Claire Foster: ORCID iD orcid.org/0000-0002-4703-8378
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755

Catalogue record

Date deposited: 09 Apr 2019 16:30
Last modified: 20 Jul 2019 04:01

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Contributors

Author: Jane Frankland ORCID iD
Author: Hazel Brodie
Author: Deborah Cooke
Author: Claire Foster ORCID iD
Author: Heather Gage
Author: Jake Jordan
Author: Ines Mesa-Eguiagaray
Author: Ruth Pickering

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