To test the feasibility and efficacy of a multifaceted model of shared care for men after completion of treatment for prostate cancer.
Men who had completed treatment for low to moderate risk prostate cancer within the previous eight weeks were eligible.
Participants were randomised to usual care or shared care. Shared care entailed substituting two hospital visits with three visits in primary care, a survivorship care plan, recall and reminders, and screening for distress and unmet needs. Outcome measures included psychological distress, prostate cancer-specific quality of life (PCSQoL), satisfaction and preferences for care and health care resource use.
88 men were randomised (Shared Care n=45; Usual Care n=43). There were no clinically important or statistically significant differences between groups on distress, PCSQoL, or satisfaction with care. At the end of the trial men in the intervention group were significantly more likely to prefer a shared care model to hospital follow-up than those in the control group Intervention 63% vs Control 24% p=0.0007). There was high compliance with PSA monitoring in both groups. The shared care model was cheaper than usual care (Shared care AUS$1,411; Usual Care AUS$1,728; difference AUS$323 (plausible range AUS$91-554)).
Well-structured shared care for men with low to moderate risk prostate cancer is feasible and appears to produce clinically comparable outcomes to standard care at lower cost. This article is protected by copyright. All rights reserved.
BJU international. 2016 Jul 19 [Epub ahead of print]
Jon D Emery, Michael Jefford, Madeleine King, Dickon Hayne, Andrew Martin, Juanita Doorey, Amelia Hyatt, Emily Habgood, Tee Lim, Cynthia Hawks, Marie Pirotta, Lyndal Trevena, Penelope Schofield
Department of General Practice, University of Melbourne, 200 Berkeley St, Carlton, Victoria, 3053, Australia., Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, 3052, Victoria, Australia., Quality of Life Office, Psycho-oncology Co-operative Research Group, School of Psychology, University of Sydney, NSW, 2006, Australia., School of Surgery, University of Western, WA, 6009, Australia., NHMRC Clinical Trials Centre, University of Sydney, NSW, 2006, Australia., School of Primary Aboriginal and Rural Health Care, University of Western Australia, Crawley, WA, 6009, Australia., Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, 3002, Australia., Department of General Practice, University of Melbourne, 200 Berkeley St, Carlton, Victoria, 3053, Australia., Genesis Cancer Care, Department of Radiation Oncology, Fiona Stanley Hospital, Perth, WA, 6150, Australia., School of Surgery, University of Western, WA, 6009, Australia., Department of General Practice, University of Melbourne, 200 Berkeley St, Carlton, Victoria, 3053, Australia., Primary Health Care, Sydney School of Public Health, The University of Sydney, NSW, 2006, Australia., Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, 3052, Victoria, Australia.