Partnership in prostate cancer (ICARE-P): using digital technology to enable primary and specialist care integration
There are over 330,000 men living with a diagnosis of prostate cancer in the UK who have followed various treatment pathways and have differing needs. Many men experience concerns due to the physical or psychological consequences of treatment or living with cancer which cannot be addressed in a stretched secondary care service. Survival rates are increasing, therefore there is a need for urgent attention as to how follow-up care and monitoring can be best delivered. Evidence suggests that patients may benefit from follow-up care in General Practice.
Research has also shown the potential of technology to aid integration of care delivery systems, through enhanced communication between the patient and his care teams.
We have developed an online holistic needs assessment (CHAT-P), and this study will test the feasibility of carrying out a large scale trial to investigate whether the use of our intervention will improve patient outcomes. This is a two-phase study. Phase 1 comprised of interviews with healthcare professionals and patients. In Phase 2, patients in the intervention arm will complete the HNA three times at three-monthly intervals, followed by a consultation with a practice or research nurse to discuss any issues identified in the HNA. Nurses will direct men to other appropriate services if needed and a care plan will be agreed. All nurses are Macmillan trained and have received prostate cancer specific training provided by the study team, and have been linked with a clinical nurse specialist in secondary care to facilitate integrated care between services.
Participants in the control arm will receive usual care. Outcomes such as quality of life, prostate specific concerns, well-being and patient enablement will be measured three times over a nine month period.
Qualitative interviews in Phase 1 showed both patients and healthcare professionals were enthusiastic about our online intervention and proposed care plan. Recruitment to Phase 2 of the study will start in March 2017.
This study is the first of its kind to trial an online HNA for prostate cancer patients, and a model of integrated care between services. We anticipate this system will provide important benefits for patients in terms of addressing unmet needs, identifying concerning symptoms and enabling self-management, and to the NHS in terms of effective use of resources.