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. 2022 Jun 28;14(13):3166.
doi: 10.3390/cancers14133166.

Specialist versus Primary Care Prostate Cancer Follow-Up: A Process Evaluation of a Randomized Controlled Trial

Barbara M Wollersheim  1   2 , Kristel M van Asselt  2 , Floris J Pos  3 , Emine Akdemir  1 , Shifra Crouse  1 , Henk G van der Poel  4 , Neil K Aaronson  1 , Lonneke V van de Poll-Franse  1   5   6 , Annelies H Boekhout  1
Affiliations

Specialist versus Primary Care Prostate Cancer Follow-Up: A Process Evaluation of a Randomized Controlled Trial

Barbara M Wollersheim et al. Cancers (Basel). .

Abstract

Background: A randomized controlled trial (RCT) is currently comparing the effectiveness of specialist- versus primary care-based prostate cancer follow-up. This process evaluation assesses the reach and identified constructs for the implementation of primary care-based follow-up. Methods: A mixed-methods approach is used to assess the reach and the implementation through the Consolidated Framework for Implementation Research. We use quantitative data to evaluate the reach of the RCT and qualitative data (interviews) to indicate the perspectives of patients (n = 15), general practitioners (GPs) (n = 10), and specialists (n = 8). Thematic analysis is used to analyze the interview transcripts. Results: In total, we reached 402 (67%) patients from 12 hospitals and randomized them to specialist- (n = 201) or to primary care-based (n = 201) follow-up. From the interviews, we identify several advantages of primary care- versus specialist-based follow-up: it is closer to home, more accessible, and the relationship is more personal. Nevertheless, participants also identified challenges: guidelines should be implemented, communication and collaboration between primary and secondary care should be improved, quality indicators should be collected, and GPs should be compensated. Conclusion: Within an RCT context, 402 (67%) patients and their GPs were willing to receive/provide primary care-based follow-up. If the RCT shows that primary care is equally as effective as specialist-based follow-up, the challenges identified in this study need to be addressed to enable a smooth transition of prostate cancer follow-up to primary care.

Keywords: Consolidated Framework for Implementation Research; follow-up care; general practice; primary health care; process evaluation; prostate cancer survivors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Consort flow diagram.
Figure 2
Figure 2
Organizational requirements necessary for the implementation of primary care-based follow-up.
See this image and copyright information in PMC

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References

    1. Carioli G., Bertuccio P., Boffetta P., Levi F., La Vecchia C., Negri E., Malvezzi M. European cancer mortality predictions for the year 2020 with a focus on prostate cancer. Ann. Oncol. 2020;31:650–658. doi: 10.1016/j.annonc.2020.02.009. - DOI - PubMed
    1. Urquhart R., Cordoba W., Bender J., Cuthbert C., Easley J., Howell D., Kaal J., Kendell C., Radford S., Sussman J. Risk Stratification and Cancer Follow-Up: Towards More Personalized Post-Treatment Care in Canada. Curr. Oncol. 2022;29:3215–3223. doi: 10.3390/curroncol29050261. - DOI - PMC - PubMed
    1. Mottet N., Cornford P., van den Bergh R.C.N., Briers E., De Santis M., Gillessen S., Grummet J., Henry A.M., van der Kwast T.H., Lam T.B., et al. Guidelines on Prostate Cancer. 2021. [(accessed on 11 April 2022)]. Available online: https://uroweb.org/guideline/prostate-cancer/
    1. Nekhlyudov L., Mollica M.A., Jacobsen P.B., Mayer D.K., Shulman L.N., Geiger A.M. Developing a Quality of Cancer Survivorship Care Framework: Implications for Clinical Care, Research, and Policy. J. Natl. Cancer Inst. 2019;111:1120–1130. doi: 10.1093/jnci/djz089. - DOI - PMC - PubMed
    1. Milonas D., Ruzgas T., Venclovas Z., Jievaltas M., Joniau S. Impact of Grade Groups on Prostate Cancer-Specific and Other-Cause Mortality: Competing Risk Analysis from a Large Single Institution Series. Cancers. 2021;13:1963. doi: 10.3390/cancers13081963. - DOI - PMC - PubMed

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