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Poster session 09

697P - The Empower Pathway overview: An innovative approach to delivering personalised care for testicular cancer survivors

Date

14 Sep 2024

Session

Poster session 09

Topics

Supportive Care and Symptom Management;  Survivorship

Tumour Site

Malignant Germ-Cell Tumours of the Adult Male

Presenters

Robert Holwell

Citation

Annals of Oncology (2024) 35 (suppl_2): S537-S543. 10.1016/annonc/annonc1591

Authors

R. Holwell1, P. Champion2, R.A. Huddart3, D. Nicol4, A. Reid1, W. Cazzaniga2, N. Kinsella2, C. Kirk5, M. Miletic6, M. Drain7

Author affiliations

  • 1 Urology, The Royal Marsden Hospital - Chelsea, SW3 6JJ - London/GB
  • 2 Urology, The Royal Marsden Hospital, SW36JJ - London/GB
  • 3 Radiotherapy And Imaging Dept., Royal Marsden Hospital Institute of Cancer Research, SM2 5NG - Sutton/GB
  • 4 Urology, Royal Marsden Hospital Institute of Cancer Research, SM2 5NG - Sutton/GB
  • 5 Performance And Information, The Royal Marsden Hospital (Sutton), SM2 5PT - Sutton/GB
  • 6 Oncology & Radiotherapy Dept., KBC Sestre Milosrdnice - University Hospital Center, 10000 - Zagreb/HR
  • 7 Uro-oncology, The Royal Marsden Hospital (Sutton), SM2 5PT - Sutton/GB

Resources

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Abstract 697P

Background

Standardised schedules for detecting testicular cancer relapse are widely employed. However, managing sequelae of treatment and empowering patients to self manage is often inconsistent within consultant-led clinics (CLC). The Empower project aimed to holistically manage patients in follow-up, whilst educating them on physical, psychological and social sequelae of treatment. This pilot of 150 patients was designed in response to local and national strategies to provide personalised stratified care.

Methods

Post-treatment patients completing 6 months of CLC surveillance were referred (with exclusions). Standard surveillance continued. Establishment and validation of the pathway involved 5 stages: 1. The Empower Team skillset was defined using an existing Experience Based Co-Design (EBCD). 2. CLC patients were surveyed on their holistic priorities. The pathway was consequentially designed; including new Scope of Practices (SOPs) addressing common unmet needs. 3. Consultations were audited. 4. Participants were re-surveyed to establish pathway effectiveness. 5. Service managers assessed impact on CLCs and implications for the wider trust.

Results

The below numbers reference stages in Methods.1. 80% agreed the skill set of a GP was suited for post treatment follow up. 2. See the table. Hypogonadism and cardiovascular pathways were created. 3. 150 patients' consultations were audited. 51.6% had a new holistic diagnosis. 100% of patients had shared care plans. 0.6% of patients required onward GP referral. 4. See the table. 5. New referrals remained stable. By 2026 a predicted 630 CLC appointments will be released. Table: 697P

CLC vs post Empower survey

Issue % of patients who felt this was important % of patients who felt this was addressed in CLC % of patient s who felt this was addressed within Empower Pathway
Lifestyle + Exercise 80 9.6 87.5
Mental Health 70 18.1 100
Sexual wellbeing 50 13.5 80.5
Shared care decision making N/A 60.6 100

Conclusions

A GP/ANP testicular cancer follow up clinic complimentary runs alongside traditional CLC, leading to improved holistic outcomes. The Empower Team has qualitatively and quantitively proven it addresses patients’ unmet needs. Crucially, CLC appointments are released giving potential to scale this model to other tumour groups and Trusts.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

RM Partners.

Disclosure

All authors have declared no conflicts of interest.

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