TY - JOUR
T1 - Patient activation and patient-reported outcomes of men from a community pharmacy lifestyle intervention after prostate cancer treatment
AU - Lemanska, Agnieszka
AU - Poole, Karen
AU - Manders, Ralph
AU - Marshall, John
AU - Nazar, Zachariah
AU - Noble, Kevin
AU - Saxton, John M.
AU - Turner, Lauren
AU - Warner, Gary
AU - Griffin, Bruce A.
AU - Faithfull, Sara
N1 - Funding Information:
This study (NIHR/UKCRN ID 20874) was funded by the Movember Foundation, in partnership with Prostate Cancer UK, as part of the global True NTH programme, grant number 250–20, and was supported by the NIHR Clinical Research Network.
Funding Information:
We thank the men and their families for their participation and contribution to the project. We thank the clinicians at the Portsmouth Hospitals NHS Trust for their help recruiting participants and Lloyds Pharmacy Ltd, Rowlands Pharmacy Ltd and City Pharmacy organisations and staff for participating in the study. We thank all members of the Study Advisory Committee for their contribution and their advisory role on the project: John Heyworth, Patient and Public Involvement, Prostate Cancer UK; Sally Greensmith, Centre for Pharmacy Postgraduate Education, University of Manchester; and Graham Phillips, Manor Pharmacy Group, Herts. Fiona Archer and Sophie Gasson are thanked for leading data entry aspects.
Funding Information:
The community pharmacy lifestyle intervention called TrueNTH Exercise and Diet ( https://prostatecanceruk.org/about-us/projects-and-policies/truenth ), funded by the Movember Foundation and Prostate Cancer UK, was developed and tested in nine community pharmacies in the Portsmouth area of the UK. The design is reported elsewhere [], but in summary, pharmacy teams were trained to deliver a health assessment including fitness, strength and anthropometric measures. Based on this health assessment, a bespoke computer algorithm generated a personalised lifestyle prescription for patients to implement at home. Participants received the prescription, verbal advice from a pharmacist and a pack of resources that included an educational DVD, a booklet with physical activity and healthy eating advice (including recipes), resistance bands for strength exercises and a pedometer to measure step count. Support was provided by two telephone calls from a pharmacist at weeks 1 and 6. Men were reassessed 3 months later at a second pharmacy consultation. Details of the intervention, its components, timelines and primary results can be found elsewhere []. PROs were administered via postal questionnaires at baseline, 3 and 6 months.
Publisher Copyright:
© 2021, The Author(s).
PY - 2022/1
Y1 - 2022/1
N2 - Purpose: To report patient activation, which is the knowledge, skills, and confidence in self-managing health conditions, and patient-reported outcomes of men after prostate cancer treatment from a community pharmacy lifestyle intervention. Methods: The 3-month lifestyle intervention was delivered to 116 men in nine community pharmacies in the UK. Patient Activation Measure (PAM) was assessed at baseline, 3 and 6 months. Prostate cancer-related function and quality of life were assessed using the European Prostate Cancer Index Composite (EPIC-26) and EuroQOL 5-dimension 5-level (EQ5D-5L) questionnaires at baseline and 6 months. Lifestyle assessments included Mediterranean Diet Adherence Screener (MEDAS) at baseline, 3 and 6 months and Godin Leisure Time Exercise Questionnaire (GLTEQ) at baseline and 3 months. Results: PAM score increased from 62 [95% CI 59–65] at baseline to 66 [64–69] after the intervention (p = 0.001) and remained higher at 6 months (p = 0.008). Scores for all the EPIC-26 domains (urinary, bowel and hormonal) were high at both assessments, indicating good function (between 74 [70–78] and 89 [86–91]), except sexual domain, where scores were much lower (21 [17–25] at baseline, increasing to 24 [20–28] at 6 months (p = 0.012)). In EQ5D-5L, 3% of men [1–9] reported self-care problems, while 50% [41–60] reported pain and discomfort, and no significant changes over time. Men who received androgen deprivation therapy, compared with those who did not, reported higher (better) urinary incontinence scores (p < 0.001), but lower (worse) scores in the urinary irritative/obstructive (p = 0.003), bowel (p < 0.001) and hormonal (p < 0.001) domains. Poor sexual function was common across all age groups irrespective of prostate cancer treatment. Conclusions: The intervention led to significant improvements in patient activation, exercise and diet. Community pharmacy could deliver effective services to address sexual dysfunction, pain and discomfort which are common after prostate cancer.
AB - Purpose: To report patient activation, which is the knowledge, skills, and confidence in self-managing health conditions, and patient-reported outcomes of men after prostate cancer treatment from a community pharmacy lifestyle intervention. Methods: The 3-month lifestyle intervention was delivered to 116 men in nine community pharmacies in the UK. Patient Activation Measure (PAM) was assessed at baseline, 3 and 6 months. Prostate cancer-related function and quality of life were assessed using the European Prostate Cancer Index Composite (EPIC-26) and EuroQOL 5-dimension 5-level (EQ5D-5L) questionnaires at baseline and 6 months. Lifestyle assessments included Mediterranean Diet Adherence Screener (MEDAS) at baseline, 3 and 6 months and Godin Leisure Time Exercise Questionnaire (GLTEQ) at baseline and 3 months. Results: PAM score increased from 62 [95% CI 59–65] at baseline to 66 [64–69] after the intervention (p = 0.001) and remained higher at 6 months (p = 0.008). Scores for all the EPIC-26 domains (urinary, bowel and hormonal) were high at both assessments, indicating good function (between 74 [70–78] and 89 [86–91]), except sexual domain, where scores were much lower (21 [17–25] at baseline, increasing to 24 [20–28] at 6 months (p = 0.012)). In EQ5D-5L, 3% of men [1–9] reported self-care problems, while 50% [41–60] reported pain and discomfort, and no significant changes over time. Men who received androgen deprivation therapy, compared with those who did not, reported higher (better) urinary incontinence scores (p < 0.001), but lower (worse) scores in the urinary irritative/obstructive (p = 0.003), bowel (p < 0.001) and hormonal (p < 0.001) domains. Poor sexual function was common across all age groups irrespective of prostate cancer treatment. Conclusions: The intervention led to significant improvements in patient activation, exercise and diet. Community pharmacy could deliver effective services to address sexual dysfunction, pain and discomfort which are common after prostate cancer.
KW - Community pharmacy
KW - Lifestyle interventions
KW - Patient-reported outcomes (PROs)
KW - Prostate cancer
UR - http://www.scopus.com/inward/record.url?scp=85110878817&partnerID=8YFLogxK
U2 - 10.1007/s00520-021-06404-5
DO - 10.1007/s00520-021-06404-5
M3 - Article
AN - SCOPUS:85110878817
VL - 30
SP - 347
EP - 358
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
SN - 0941-4355
IS - 1
ER -