Enhanced Patient Activation in Cancer Care Transitions: Protocol for a Randomized Controlled Trial of a Tailored Electronic Health Intervention for Men With Prostate Cancer

Abstract

Background Prostate cancer has increased in incidence worldwide and is the leading cause of cancer death in 24 countries. The most common treatment is radical prostatectomy. However, surgery is associated with postoperative complications such as urinary incontinence and sexual dysfunction, causing decreased quality of life. If survivors are encouraged to be more active in self-care management, the symptom burden may decrease and quality of life may improve. An electronic health (eHealth) intervention based on motivational behavioral theory has been developed for this purpose. Objective This study aimed to compare the effectiveness of standard care in combination with a tailored eHealth and mobile health self-management support system, electronic Patient Activation in Treatment at Home (ePATH), with standard care of adverse effects of prostate cancer treatment (urinary incontinence and sexual functioning) in men undergoing radical prostatectomy. The secondary aim was to test the effect on patient activation, motivation, overall well-being, and health literacy over time in and between groups. Methods A pragmatic multicenter, block-randomized controlled trial with 2 study arms, standard care (control) and eHealth-assisted standard care (intervention), for patients undergoing radical prostatectomy. For 80% power, a sample of 242 men will need to be recruited. Results Recruitment started in January 2018 and is expected to be completed by August 2019. Data collection will be completed in August 2020. The first cross-sectional results from this trial are anticipated to be published in January 2020. Conclusions With the increasing number of prostate cancer survivors, attention should be paid to rehabilitation, psychosocial care, and support for endurance of self-care to reduce suffering from adverse treatment effects, poor quality of life, and depression because of postoperative complications. This project may increase knowledge of how patients can be supported to feel involved in their care and returning to as normal a life as possible. The anticipated effects of ePATH could improve health outcomes for individuals and facilitate follow-up for health care professionals. Trial Registration International Standard Randomised Controlled Trial Number: 18055968; http://www.isrctn.com/ISRCTN18055968 (Archived by WebCite at http://www.isrctn.com/ISRCTN18055968). International Registered Report Identifier (IRRID) DERR1-10.2196/11625

Patients’ experiences of using an e-Health tool for self-management support after prostate cancer surgery: a deductive interview study explained through the FITT framework

“…Further, there is a messaging function, allowing the patient to send text-based messages to his contact nurse, and the contact nurse has the possibility to respond or send supportive messages to the patient. 20 Open access Patient and public involvement User-centred design approach was used as it provides a variety of methods (e.g. interviews, think-aloud techniques) to allow end users to influence how the product takes shape.…”

“…These limitations will be addressed further in evaluation of the application and user log data will be extracted in the ongoing effectiveness study to review actual use. 20 Conclusions and future research Advances in treatment have led to longer survival after prostate cancer diagnosis, but that does not automatically mean that survivors are living well. A substantial group of men surviving prostate cancer are experiencing longterm physical side effects and heightened psychological distress, indicating a need for long-term rehabilitation support and availability of healthcare.…”

“…The current study has provided information on development of additional features of relevance for the users. There is an ongoing Randomised Controlled Trial using ePATH, 20 in which a mobile application for rating symptoms is also available. However, elements of gamification, as suggested by the participants in the study of Jessen et al, 26 are still to be developed.…”

Improved cancer coping from a web‐based intervention for prostate cancer survivors: A randomized controlled trial

“…Supportive interventions should comprehensively focus on PCa survivors' functional, psychological, and adjustment needs. However, existing interventions typically focus on one need 7–15 and are resource‐intensive, limiting their scalability 16–18 . As more cancer survivors are seeking health information online, 19 web‐based interventions have demonstrated improved patient‐reported outcomes 12 .…”

Effects of Pharmacist-Led Clinical Pathway/Order Sets on Cancer Patients: A Systematic Review

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