The objective of the study is to dimplement and evaluate a new care path for elderly prostate cancer patients with complex care needs within 20 months. This will be done withinthe department of urology at the Meander Medisch Centrum at Amersfoort,…
ID
Source
Brief title
Condition
- Reproductive neoplasms male malignant and unspecified
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary outcome measure of this project is the existence of a succesful
clinical pathway for older prostate cancer patients. This will be assessed by
the following criteria:
- GPs do not refer patients to the urologist (unless for recurrence/metastasis).
- The majority of the patients is satisfied
- The participating GPs and urologists are convinced and confident
Secondary outcome
perceived quality of care and prostate cancer specific quality of life, health
care use and satisfaction with videoconsultations
Background summary
Half of the patients who have been diagnosed with prostate cancer is over 70
years and many patients suffer from other chronic diseases in addition to
prostate cancer. The treatment of prostate cancer can be influenced by these
additional diseases and vice versa. Also, several different care providers will
be involved in the care for elderly patients with complex care needs.
Therefore, a patient-centred approach that goes beyond the disease is needed.
It could turn out to be positive when GPs are more involved in the after-care
for prostate cancer. The GP has, as generalist a good overall picture of the
complete medical and psycho-social situation of the patient. Many patients see
their GP already regularly and care needs might be combined within one
consultation. Patient do not have to travel far. It is also advantageous for
the GP that he has a more complete picture of the health situation of the
patient and it could save money.
Shifting the complete after-care to the GP might not be possible and not
desirable, because specific oncological expertise is needed. Teleconsultation
might be the solution. The specialist can be virtually present at a GP
consultation in videoconsultation, and vice versa. The result is streamlined
multidisciplinary care with the real focus on the patient. This way,
multi-agency cooperation, patient participation and patient satisfaction can be
improved. In addition, the GP extends his oncological knowledge.
Study objective
The objective of the study is to dimplement and evaluate a new care path for
elderly prostate cancer patients with complex care needs within 20 months. This
will be done withinthe department of urology at the Meander Medisch Centrum at
Amersfoort, in cooperation with several GP practices in the Amersfoort region.
Study design
In the clinical pathway, the care for the patients in the after-care phase will
be shifted from specialist to GP, supported by videoconsultation with
urologists or geriatrician, where needed.
At the start of the project, the participating GPs and urologists have jointly
developed a treatment protocol for the after-care of prostate cancer for GPs.
This will be implemented at the Meander MC and several GP practices in the
Amersfoort region . When patient and GP agree, patients with prostate cancer in
these practices will receive after-care during 12 months according to the
clinical pathway.
At the end of the project interviews will be conducted with the participating
patients, GPs and specialists, about their experiences. For every patient who
joins the project, the quality of care from the perspective of the patient and
prostate cancer specific quality of life will be measured before the after-care
and after a year. Care use will be extracted from the patient information
system of the GP and the Meander MC. Also, the patients will be asked for their
care use in other hospitals after 6 and 12 months.
Study burden and risks
Burden and risks associated with participation are low. Patient are asked to
fill out a questionnaire at the start of the study and after 6 months, taking
approximately 10 minutes, and the end of the study, taking approximately 30
minutes. Besides they are asked to be interviewed by one of the researchers,
which will take approximately 30 minutes.
Otterstraat 118 - 124
Utrecht 3512 CR
NL
Otterstraat 118 - 124
Utrecht 3512 CR
NL
Listed location countries
Age
Inclusion criteria
In order to be eligible to participate in this study, a subject must meet all of the following criteria:
• Diagnosis of prostate cancer
• Age at least 65 and at least one chronic disease (of a list of 30 diseases of the RIVM);Specific criteria for the different treatment options:
After radical prostatectomy inclusion 1 year after operation if:
• PSA < 0,1
• No other active treatment by urologist (for example erectile dysfunction or incontinence)
After radiotherapy (in- or external) inclusion 1 year after radiotherapy if:
• PSA declining
• No other active treatment by urologist (for example erectile dysfunction or incontinence)
Watchful waiting inclusion 6 months after start watchful waiting if:
• PSA stable
• No other active treatment by urologist (for example erectile dysfunction or incontinence)
Hormone therapy inclusion 6 months after start hormone therapy if:
• Health complaints absent or stable
Exclusion criteria
- In active medical treatment
- After-care by GP not medically safe
- in the normal situation the patient would be checked by the urologist for at least one year
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL47835.100.14 |