Abstract
Introduction: Prostate cancer is a common cancer form and radical prostatectomy (RP) is a frequently used treatment, which can leave patients with urinary incontinence and sexual dysfunction. Self-care (pelvic floor muscle exercises, PFME, and physical activity) are recommended to reduce side-effect. As an increasing number of patients live in the aftermath of treatment, effective rehabilitation support is warranted. Digital solutions have the potential to add support, but are sparsely evaluated longitudinally in randomized control trials. We therefore developed and evaluated the efficiency an eHealth self-care support (ePATH) to increase patient knowledge, skills and confidence to be active in self-care.
Aim and Methods: The aim was to investigate the effectiveness of an e-Health self-care support on urinary incontinence and sexual function, compared with standard care, at 1, 3, 6 and 12 months after RP. A pragmatic multicenter randomized controlled trial with two study arms was conducted, where the longitudinal effects of the eHealth self-care support were compared with standard care for patients who had undergone RP. The study included 166 patients. The effects of ePATH were evaluated over one year past surgery using a linear mixed model.
Results: Patients in intervention and control group did not differ on demographics characteristics. Data is currently under analysis, and the preliminary linear mixed model showed no significant difference between groups on urinary incontinence or sexual function at any time point. Patients in the intervention group performed significantly more PFME, than the control group at 6 to 12 months postoperative. Patients who experienced more urinary incontinence performed more PFME.
Conclusions: ePATH did not affect side-effects postoperative. However, the digital support seemed to increase endurance to perform PFME. Further studies should focus on adapting the eHealth support to the clinical context and explore which patients who benefit most before implementation.
Implications for applicability/transferability, sustainability, and limitations: Evaluating complex interventions, that target behavioral change in self-care management, need to consider multiple aspects. Technical literacy, user´s attitude or discrepancy between patient needs and content of the application may have affected the outcome. The limited number of patients could reduce the study´s transferability.