Patient activation and patient-reported outcomes of men from a community pharmacy lifestyle intervention after prostate cancer treatment

Springer Science and Business Media LLC - Tập 30 - Trang 347-358 - 2021
Agnieszka Lemanska1, Karen Poole1, Ralph Manders2, John Marshall3, Zachariah Nazar4, Kevin Noble5, John M. Saxton6, Lauren Turner7, Gary Warner5, Bruce A. Griffin2, Sara Faithfull1
1School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
2Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
3Patient and Public Involvement, Prostate Cancer UK, London, UK
4Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
5Pinnacle Health Partnership LLP, East Cowes, UK
6Department of Sport, Health and Exercise Science, Faculty of Health Sciences, University of Hull, Hull, UK
7Frimley Health NHS Foundation Trust, Frimley, UK

Tóm tắt

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. 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. 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. 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.

Tài liệu tham khảo

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