A Single Educational Seminar Increases Confidence and Decreases Dropout from Active Surveillance by 5 Years After Diagnosis of Prostate Cancer

Netty Kinsella; Kerri Beckmann; Declan Cahill; Oussama Elhage; Rick Popert; Paul Cathcart; Ben Challacombe; Christian Brown; Mieke Van Hemelrijck

doi:10.1016/j.euo.2018.09.007

A Single Educational Seminar Increases Confidence and Decreases Dropout from Active Surveillance by 5 Years After Diagnosis of Prostate Cancer

Netty Kinsella, Kerri Beckmann, Declan Cahill, Oussama Elhage, Rick Popert, Paul Cathcart, Ben Challacombe, Christian Brown, Mieke Van Hemelrijck

Research output: Contribution to journal › Article › peer-review

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Abstract

Background
Researchers remain divided on the major causes of dropout from active surveillance (AS), with rates of up to 38% among men with no evidence of prostate cancer (PC) progression.

Objective
To develop and evaluate an educational intervention in terms of adherence to AS among men with low- to intermediate-risk PC.

Design, setting, and participants
We first carried out focus group discussions with men who had remained on and dropped out of AS to inform an intervention to increase adherence to AS. A total of 255 consecutive men who had selected AS were then recruited to either standard care (written information and access to a nurse specialist) or standard care and the intervention.

Intervention
An educational seminar was designed by patients and clinicians including information on imaging, biopsy techniques, understanding pathology, large AS cohorts - mortality and morbidity risk and diet and lifestyle advice.

Outcome measurements and statistical analysis
The proportion of men dropping out of AS for reasons other than disease progression was assessed at 1 and 5 yr after AS selection using multivariate logistic regression.

Results and limitations
Common themes influencing decision-making by men on AS were identified: (1) clinical consistency; (2) information; and (3) lifestyle advice. Addition of an educational seminar led to significantly fewer men dropping out of AS: at 1 and 5 yr the dropout rate was 25% and 42%, respectively, in the standard care group, compared to 11% and 22% (p = 0.001) in the intervention group. In the intervention group, 18 men failed to attend the seminar.

Conclusions
The AS dropout rate was halved following a single educational seminar delivered to groups of men with intermediate- or low-risk PC, even at 5 yr.

Patient summary
Men on active surveillance (AS) for prostate cancer feel more supported when provided with an educational seminar within 3 mo of their treatment choice. The seminar halved the number of men dropping-out of AS, even at 5 yr.

Original language	English
Journal	European Urology Oncology
Early online date	11 Oct 2018
DOIs	https://doi.org/10.1016/j.euo.2018.09.007
Publication status	E-pub ahead of print - 11 Oct 2018

Keywords

Prostate cancer
Active surveillance
Intervention
Adherence

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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A Single Educational Seminar_KINSELLA_Accepted16September2018_GREEN AAM (CC BY-NC-ND)Accepted author manuscript, 360 KBLicence: CC BY-NC-ND
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Cite this

Kinsella, N., Beckmann, K., Cahill, D., Elhage, O., Popert, R., Cathcart, P., Challacombe, B., Brown, C., & Van Hemelrijck, M. (2018). A Single Educational Seminar Increases Confidence and Decreases Dropout from Active Surveillance by 5 Years After Diagnosis of Prostate Cancer. European Urology Oncology. Advance online publication. https://doi.org/10.1016/j.euo.2018.09.007

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title = "A Single Educational Seminar Increases Confidence and Decreases Dropout from Active Surveillance by 5 Years After Diagnosis of Prostate Cancer",

abstract = "BackgroundResearchers remain divided on the major causes of dropout from active surveillance (AS), with rates of up to 38% among men with no evidence of prostate cancer (PC) progression.ObjectiveTo develop and evaluate an educational intervention in terms of adherence to AS among men with low- to intermediate-risk PC.Design, setting, and participantsWe first carried out focus group discussions with men who had remained on and dropped out of AS to inform an intervention to increase adherence to AS. A total of 255 consecutive men who had selected AS were then recruited to either standard care (written information and access to a nurse specialist) or standard care and the intervention.InterventionAn educational seminar was designed by patients and clinicians including information on imaging, biopsy techniques, understanding pathology, large AS cohorts - mortality and morbidity risk and diet and lifestyle advice.Outcome measurements and statistical analysisThe proportion of men dropping out of AS for reasons other than disease progression was assessed at 1 and 5 yr after AS selection using multivariate logistic regression.Results and limitationsCommon themes influencing decision-making by men on AS were identified: (1) clinical consistency; (2) information; and (3) lifestyle advice. Addition of an educational seminar led to significantly fewer men dropping out of AS: at 1 and 5 yr the dropout rate was 25% and 42%, respectively, in the standard care group, compared to 11% and 22% (p = 0.001) in the intervention group. In the intervention group, 18 men failed to attend the seminar.ConclusionsThe AS dropout rate was halved following a single educational seminar delivered to groups of men with intermediate- or low-risk PC, even at 5 yr.Patient summaryMen on active surveillance (AS) for prostate cancer feel more supported when provided with an educational seminar within 3 mo of their treatment choice. The seminar halved the number of men dropping-out of AS, even at 5 yr.",

keywords = "Prostate cancer, Active surveillance, Intervention, Adherence",

author = "Netty Kinsella and Kerri Beckmann and Declan Cahill and Oussama Elhage and Rick Popert and Paul Cathcart and Ben Challacombe and Christian Brown and {Van Hemelrijck}, Mieke",

year = "2018",

month = oct,

day = "11",

doi = "10.1016/j.euo.2018.09.007",

language = "English",

journal = "European Urology Oncology",

issn = "2588-9311",

publisher = "Elsevier BV",

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TY - JOUR

T1 - A Single Educational Seminar Increases Confidence and Decreases Dropout from Active Surveillance by 5 Years After Diagnosis of Prostate Cancer

AU - Kinsella, Netty

AU - Beckmann, Kerri

AU - Cahill, Declan

AU - Elhage, Oussama

AU - Popert, Rick

AU - Cathcart, Paul

AU - Challacombe, Ben

AU - Brown, Christian

AU - Van Hemelrijck, Mieke

PY - 2018/10/11

Y1 - 2018/10/11

N2 - BackgroundResearchers remain divided on the major causes of dropout from active surveillance (AS), with rates of up to 38% among men with no evidence of prostate cancer (PC) progression.ObjectiveTo develop and evaluate an educational intervention in terms of adherence to AS among men with low- to intermediate-risk PC.Design, setting, and participantsWe first carried out focus group discussions with men who had remained on and dropped out of AS to inform an intervention to increase adherence to AS. A total of 255 consecutive men who had selected AS were then recruited to either standard care (written information and access to a nurse specialist) or standard care and the intervention.InterventionAn educational seminar was designed by patients and clinicians including information on imaging, biopsy techniques, understanding pathology, large AS cohorts - mortality and morbidity risk and diet and lifestyle advice.Outcome measurements and statistical analysisThe proportion of men dropping out of AS for reasons other than disease progression was assessed at 1 and 5 yr after AS selection using multivariate logistic regression.Results and limitationsCommon themes influencing decision-making by men on AS were identified: (1) clinical consistency; (2) information; and (3) lifestyle advice. Addition of an educational seminar led to significantly fewer men dropping out of AS: at 1 and 5 yr the dropout rate was 25% and 42%, respectively, in the standard care group, compared to 11% and 22% (p = 0.001) in the intervention group. In the intervention group, 18 men failed to attend the seminar.ConclusionsThe AS dropout rate was halved following a single educational seminar delivered to groups of men with intermediate- or low-risk PC, even at 5 yr.Patient summaryMen on active surveillance (AS) for prostate cancer feel more supported when provided with an educational seminar within 3 mo of their treatment choice. The seminar halved the number of men dropping-out of AS, even at 5 yr.

AB - BackgroundResearchers remain divided on the major causes of dropout from active surveillance (AS), with rates of up to 38% among men with no evidence of prostate cancer (PC) progression.ObjectiveTo develop and evaluate an educational intervention in terms of adherence to AS among men with low- to intermediate-risk PC.Design, setting, and participantsWe first carried out focus group discussions with men who had remained on and dropped out of AS to inform an intervention to increase adherence to AS. A total of 255 consecutive men who had selected AS were then recruited to either standard care (written information and access to a nurse specialist) or standard care and the intervention.InterventionAn educational seminar was designed by patients and clinicians including information on imaging, biopsy techniques, understanding pathology, large AS cohorts - mortality and morbidity risk and diet and lifestyle advice.Outcome measurements and statistical analysisThe proportion of men dropping out of AS for reasons other than disease progression was assessed at 1 and 5 yr after AS selection using multivariate logistic regression.Results and limitationsCommon themes influencing decision-making by men on AS were identified: (1) clinical consistency; (2) information; and (3) lifestyle advice. Addition of an educational seminar led to significantly fewer men dropping out of AS: at 1 and 5 yr the dropout rate was 25% and 42%, respectively, in the standard care group, compared to 11% and 22% (p = 0.001) in the intervention group. In the intervention group, 18 men failed to attend the seminar.ConclusionsThe AS dropout rate was halved following a single educational seminar delivered to groups of men with intermediate- or low-risk PC, even at 5 yr.Patient summaryMen on active surveillance (AS) for prostate cancer feel more supported when provided with an educational seminar within 3 mo of their treatment choice. The seminar halved the number of men dropping-out of AS, even at 5 yr.

KW - Prostate cancer

KW - Active surveillance

KW - Intervention

KW - Adherence

U2 - 10.1016/j.euo.2018.09.007

DO - 10.1016/j.euo.2018.09.007

M3 - Article

SN - 2588-9311

JO - European Urology Oncology

JF - European Urology Oncology

ER -

A Single Educational Seminar Increases Confidence and Decreases Dropout from Active Surveillance by 5 Years After Diagnosis of Prostate Cancer

Abstract

Keywords

UN SDGs

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