Publication date

Feasibility and acceptability of follow-up for prostate cancer in primary care.

Heins, M.J., Schellevis, F.G., Schotman, M., Bezooijen, B.P.J. van, Tchaoussoglou, I.C., Waart, M.A.C. van der, Veldhuis, L.T.M., Dulmen, A.M. van, Donker, G.A., Korevaar, J.C. Feasibility and acceptability of follow-up for prostate cancer in primary care. In: Abstractbook Ca-PRI the Cancer and Primary care Research International network Conference: Edinburg, 19th of April 2017.
The number of prostate cancer patients is high and will increase further due to the ageing population. Follow-up for prostate cancer will therefore put an increasing demand on health care capacity and costs. Increasing the role of the GP in follow-up for prostate cancer may help to limit the work load in secondary care and reduce costs. Before testing cost-effectiveness in a large trial, feasibility and acceptability should first be tested in a smaller sample.

We tested the feasibility and acceptability of a new clinical pathway for patients with prostate cancer in a stable phase aged ≥65 years and with comorbidity. Follow-up for prostate cancer was transferred to the GP and patients were followed for one year.
We aimed to include 20 patients. Participating GPs and urologists jointly developed a protocol. Patient satisfaction regarding GP care was measured 0 and 12 months after transfer of care to the GP with the subscale ‘personalized care’ of the Consumer Quality Index GP-care. Next, patients, GPs and urologists were interviewed about their experiences. We considered the clinical pathway successful if no patients were referred back to the urologist except for an increase in PSA, and if the majority of patients and participating urologists and GPs were satisfied.

Of the 20 patients included in the study, three were referred back to the urologist because of increasing PSA levels and one died (unrelated to prostate cancer). Most patients (73%) were satisfied with the transfer of care, indicated by a score of 3 or higher on the subscale ‘personalized care’. GPs and urologists were confident in GPs’ ability to provide follow-up for prostate cancer and preferred to continue this.

The new clinical pathway was successful. This warrants a larger study to provide evidence for the (cost-) effectiveness of GP-led prostate cancer follow-up.