Researchers at Memorial Sloan Kettering Cancer Center explored the potential of shared medical appointments (SMAs) as an effective and efficient way to provide follow-up care for the growing number of men with prostate cancer undergoing active surveillance. The findings of their investigation were published in Urology Practice.
Active surveillance is an increasingly common way to monitor men with prostate cancer, and the researchers were concerned that “the increased patient volume will negatively affect patient experience, with rushed visits and little time for in-depth discussions.”
So the researchers proposed the innovative redesign of their clinic systems. Men with clinically localized low or low-intermediate risk prostate cancer who were scheduled for a follow-up surveillance visit were invited to participate in the pilot program. Of 64 invited men, 26 patients participated in four SMAs of 6 to 8 men each (along with any caregivers who wanted to join them).
The SMAs were held between July 2019 and November 2019. Each appointment comprised three parts: a 20-minute patient-education session, a 20- to 30-minute clinical management discussion and support from the medical team and group members, and one-on-one physical examinations in a urology clinic room. Every patient was allotted time to ask questions and discuss their symptoms and treatment options.
Each patient completed a survey after attending the SMA to gauge their reaction to the experience. Survey results indicated participants had a positive experience.
“The majority of the 26 patients rated their overall experience with SMA as excellent: 22 (85%) excellent and 4 (15%) very good,” the researchers reported. “Almost all patients responded that they were likely or very likely to attend another SMA in the future: 22 (85%) very likely, 3 (12%) likely, and 1 (4%) unsure.”
Although the team of researchers concluded that using SMAs for active surveillance follow-up visits was both feasible and acceptable, this project did have some limitations. For example, providers selected participants based on being the right “fit” for a group session, which may have had an effect on their satisfaction. “This is also a small proof-of-concept quality improvement project,” the researchers added, “as such, the small numbers and single institution design limit generalizability to other practices.”
Disclosure: Multiple authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Carlsson SV, Claus C, Benfante N, et al. Shared medical appointments for prostate cancer active surveillance followup visits. Urology Practice. Sept. 2021; 8. 541-545. https://doi.org/10.1097/UPJ.0000000000000247