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

Frankland, Jane, Brodie, Hazel, Cooke, Debbie, Foster, Claire, Foster, Rebecca, 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 (1).

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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 followup 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.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
NameEmailORCID
Frankland, Jane
Brodie, Hazel
Cooke, Debbied.cooke@surrey.ac.uk
Foster, Claire
Foster, Rebecca
Gage, HeatherH.Gage@surrey.ac.uk
Jordan, Jakejake.jordan@surrey.ac.uk
Mesa-Eguiagaray, Ines
Pickering, Ruth
Richardson, Alison
Date : 23 April 2019
Funders : The Movember Foundation, Prostate Cancer UK
DOI : 10.1186/s12885-019-5561-0
Grant Title : The TrueNTH programme
Copyright Disclaimer : © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Uncontrolled Keywords : Evaluation; Cancer; Follow-up care; Prostate; Patient-led; Patient-triggered; Supported self-management; Remote surveillance; Effectiveness; Cost-effectiveness
Depositing User : Diane Maxfield
Date Deposited : 02 Oct 2019 11:06
Last Modified : 02 Oct 2019 13:44
URI: http://epubs.surrey.ac.uk/id/eprint/852855

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