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Online delivery of prostate cancer nursing and allied health care
Australian Prostate Cancer Research
Dr Addie Wootten - eHealth Program Manager and Clinical Psychologist
This project aimed to develop and pilot test the integration of real-time nursing and allied health clinical consultations for men with prostate cancer over the Internet. The PROSTMATE system delivers information, clinical assessment, education and support via a tele-health model that can be integrated into the public or private healthcare setting and lead into a sustainable model of care.
This pilot study evaluated the clinical integration of the PROSTMATE system into clinical practice at Peter MacCallum Cancer Centre. Men undergoing treatment for localised prostate cancer, or those who had recently completed treatment, were invited to participate. Of the 42 men who were eligible to participate, 21 men consented to participate. Fourteen men and one partner actively engaged in the PROSTMATE system.
Seven structured interviews were also conducted with participants to explore their experiences using the system, identify any barriers to access or difficulties encountered and to explore any suggestions for improvement to the system.
A number of themes emerged from these interviews:
1. The importance of information
e.g. “I started using PROSTMATE a month before surgery – timing was perfect and it was an excellent source of information along the way. You can’t always get people on the phone and you don’t want to hound them so having this where you can access information at your own leisure was excellent. And you can find answers to almost all your questions there in one place.”
2. The benefits of monitoring outcomes and navigating the system
e.g. “Sometimes if you are feeling ok when you see the nurse you might forget about problems you’ve had in the time before, so this could be a good reminder or prompt to talk about these issues – especially if she used these questions as a guide to ask about how we are going.”
3. Feeling in control and recording a personal medical record
e.g. “I put notes in there as things were happening… how many pads per day I was using, details of catheter… to help me keep track and also to help others.”
4. Improving accessibility and reducing costs and time wastage through telehealth
e.g. “I’m from Canberra – spend more money when you have to travel so far, I’d be happy to use this system if it meant I didn’t have to travel down to Melbourne so often.”
PROSTMATE has been in development since 2012. During 2013 the online platform, PROSTMATE, was pilot tested and preliminary data indicated that the program is engaging, user friendly and will have a significant impact on improving the quality of life of men with prostate cancer. PROSTMATE was launched to the public in November 2013 and is freely accessible to anyone affected by prostate cancer. As at May 2015, there are more than 1400 people using the public site.
Participant feedback about the PROSTMATE system was excellent. The majority of participants felt that it was a valuable resource and that the tools to track their progress were particularly beneficial. The use of the telehealth component was very low, however this appeared to be related to systemic challenges of competing services within the pilot hospital site and the short duration of the pilot did not allow for integration of these two systems. Further refinement and engagement is required.
This pilot project demonstrates feasibility and accessibility of the service, however further improvements are indicated and ongoing integration work with the clinical team is required.
Areas for Improvement
Areas for Improvement
Whilst PROSTMATE has been optimized for use on a tablet or mobile device, some participants felt that an App would provide greater flexibility and access to the program, particularly for tracking their outcomes and logging appointment, treatments and test results.
It is also recommended that this program be pilot tested with a range of other patient groups. The current study focused on localised prostate cancer patients who were, on the whole, very well. It is recommended that further evaluation be undertaken with men, and their partners, who are living with more advanced prostate cancer also.
Australian Prostate Cancer Research is committed to continuing the pioneering work of evaluating the integration of the PROSTMATE system into clinical practice. Pilot work will continue at Royal Melbourne Hospital and the newly established Australian Centre for Prostate Cancer and Mens health. The use of the PROSTMATE system will also continue at Peter MacCallum Cancer Centre. Australian Prostate Cancer Research plans to use the knowledge gained from this pilot study to inform future larger-scale clinical integration studies.
One publication has been produced about the project in the British Journal of Urology International Blog, May 2014: http://www.bjuinternational.com/bjui-blog/prostmate/
PROSTMATE was a Finalist for the 2014 Australia and New Zealand Internet Awards (ANZIAs) in two categories – Information and Innovation. PROSTMATE received the Highly Commended award for the Innovation category.