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Integrated care in prostate cancer (ICARE-P) : nonrandomized controlled feasibility study of online holistic needs assessment, linking the patient and the health care team
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Nanton, Veronica, Appleton, Rebecca, Dale, Jeremy, Roscoe, Julia, Hamborg, Thomas, Ahmedzai, Sam H., Arvanitis, Theodoros N., Badger, Douglas, James, Nicholas, Mendelsohn, Richard, Khan, Mohammed Omar, Parashar, Deepak and Patel, Prashant (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 Research Protocols, 6 (7). e147. doi:10.2196/resprot.7667 ISSN 1929-0748.
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Official URL: http://dx.doi.org/10.2196/resprot.7667
Abstract
Background: The potential of technology to aid integration of care delivery systems is being explored in a range of contexts across a variety of conditions in the United Kingdom. Prostate cancer is the most common cancer in UK men. With a 10-year survival rate of 84%, there is a need to explore innovative methods of care that are integrated between primary health care providers and specialist teams in order to address long-term consequences of the disease and its treatment as well as to provide continued monitoring for recurrence.
Objective: Our aim was to test the feasibility of a randomized controlled trial to compare a model of prostate cancer continuing and follow-up care integration, underpinned by digital technology, with usual care in terms of clinical and cost-effectiveness, patient-reported outcomes, and experience.
Methods: A first phase of the study has included development of an online adaptive prostate specific Holistic Needs Assessment system (HNA), training for primary care-based nurses, training of an IT peer supporter, and interviews with health care professionals and men with prostate cancer to explore views of their care, experience of technology, and views of the proposed intervention. In Phase 2, men in the intervention arm will complete the HNA at home to help identify and articulate concerns and share them with their health care professionals, in both primary and specialist care. Participants in the control arm will receive usual care. Outcomes including quality of life and well-being, prostate-specific concerns, and patient enablement will be measured 3 times over a 9-month period.
Results: Findings from phase 1 indicated strong support for the intervention among men, including those who had had little experience of digital technology. Men expressed a range of views on ways that the online system might be used within a clinical pathway. Health care professionals gave valuable feedback on how the output of the assessment might be presented to encourage engagement and uptake by clinical teams. Recruitment to the second phase of the study, the feasibility trial, commenced March 2017.
Conclusions: To our knowledge, this study is the first in the United Kingdom to trial an online holistic needs assessment for men with prostate cancer, with data shared between patients and primary and secondary care providers. This study addresses recommendations in recent policy documents promoting the importance of data sharing and enhanced communication between care providers as a basis for care integration. We anticipate that this model of care will ultimately provide important benefits for both patients and the National Health Service.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RA Public aspects of medicine | ||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School Faculty of Science, Engineering and Medicine > Engineering > WMG (Formerly the Warwick Manufacturing Group) |
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| Library of Congress Subject Headings (LCSH): | Prostate -- Cancer -- Treatment, Integrated delivery of health care -- Great Britain, Quality of life, Medical care -- Technological innovations, Internet in medicine | ||||||
| Journal or Publication Title: | JMIR Research Protocols | ||||||
| Publisher: | J M I R Publications, Inc. | ||||||
| ISSN: | 1929-0748 | ||||||
| Official Date: | 28 July 2017 | ||||||
| Dates: |
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| Volume: | 6 | ||||||
| Number: | 7 | ||||||
| Article Number: | e147 | ||||||
| DOI: | 10.2196/resprot.7667 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 9 August 2017 | ||||||
| Date of first compliant Open Access: | 10 August 2017 | ||||||
| Funder: | National Institute for Health research (Great Britain). Research for Patient Benefit Programme (NIHR RPB) | ||||||
| Grant number: | PB-PG-0214-33092 (NIHR) |
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