BACKGROUND: Little is known about the constraints of optimizing health care for prostate cancer survivors in Alaska primary care.
OBJECTIVE: To describe the experiences and attitudes of primary care providers within the Alaska Tribal Health System (ATHS) regarding the care of prostate cancer survivors.
DESIGN: In late October 2011, we emailed a 22-item electronic survey to 268 ATHS primary care providers regarding the frequency of Prostate Specific Antigen (PSA) monitoring for a hypothetical prostate cancer survivor; who should be responsible for the patient's life-long prostate cancer surveillance; who should support the patient's emotional and medical needs as a survivor; and providers' level of comfort addressing recurrence monitoring, erectile dysfunction, urinary incontinence, androgen deprivation therapy, and emotional needs. We used simple logistic regression to examine the association between provider characteristics and their responses to the survivorship survey items.
RESULTS: Of 221 individuals who were successfully contacted, a total of 114 responded (52% response rate). Most ATHS providers indicated they would order a PSA test every 12 months (69%) and believed that, ideally, the hypothetical patient's primary care provider should be responsible for his life-long prostate cancer surveillance (60%). Most providers reported feeling either "moderately" or "very" comfortable addressing topics such as prostate cancer recurrence (59%), erectile dysfunction (64%), urinary incontinence (63%), and emotional needs (61%) with prostate cancer survivors. These results varied somewhat by provider characteristics including female sex, years in practice, and the number of prostate cancer survivors seen in their practice.
CONCLUSIONS: These data suggest that most primary care providers in Alaska are poised to assume the care of prostate cancer survivors locally. However, we also found that large minorities of providers do not feel confident in their ability to manage common issues in prostate cancer survivorship, implying that continued access to specialists with more expert knowledge would be beneficial.
Written by:
Tilburt JC, Kelley S, DeCourtney CA, Humeniuk KM, Latini J, Kim SP. Are you the author?
Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA; Biomedical Ethics Program, Mayo Clinic, Rochester, MN, USA; Knowledge & Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA; Robert D. and Patrician E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA; Clinical and Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA; Biomedical Ethics Program, Mayo Clinic, Rochester, MN, USA; Department of Urology, Alaska Native Medical Center, Anchorage, AK, USA; Department of Urology, Yale University, New Haven, CT, USA.
Reference: Int J Circumpolar Health. 2014 Feb 27;73:23637.
doi: 10.3402/ijch.v73.23637
PubMed Abstract
PMID: 24596707
UroToday.com Prostate Cancer Section
