Journal Article

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

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

2020

Overview

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.

• Publisher: Springer Berlin Heidelberg,Springer,Springer Nature B.V
• Subject: Acceptability / Aged / Aged, 80 and over / Analysis / Cancer / Care and treatment / Delivery of Health Care, Integrated - methods / Delivery of Health Care, Integrated - organization & administration / Delivery of Health Care, Integrated - standards / Family medicine / Feasibility / Feasibility Studies / General practice / Health care / Health Personnel - organization & administration / Health Personnel - standards / Health Promotion - methods / Health services / Holistic Health - standards / Holistic nursing / Humans / Integrated care / Intervention / Male / Medical personnel / Medicine / Medicine & Public Health / Men / Middle Aged / Needs analysis / Needs Assessment / Nurse led services / Nurses / Nursing / Nursing care / Nursing Research / Oncology / Oncology, Experimental / Online Systems / Original / Original Article / Pain Medicine / Patient assessment / Patient Care Planning - organization & administration / Patient Care Planning - standards / Patient communication / Patient-Centered Care - methods / Patient-Centered Care - organization & administration / Patient-Centered Care - standards / Patients / Practice nurses / Practice nursing / Primary care / Primary Health Care - methods / Primary Health Care - organization & administration / Primary Health Care - standards / Professional-Patient Relations / Prostate / Prostate cancer / Prostatic Neoplasms - therapy / Quality of Life / Recruitment / Referral and Consultation - organization & administration / Referral and Consultation - standards / Rehabilitation Medicine / Survivor / Telemedicine - methods / Telemedicine - organization & administration / Telemedicine - standards