Specialist versus Primary Care Prostate Cancer Follow-Up: A Process Evaluation of a Randomized Controlled Trial

Area of Science:

• Oncology
• Health Services Research
• Implementation Science

Background:

• A randomized controlled trial (RCT) is evaluating specialist vs. primary care for prostate cancer follow-up.
• This process evaluation focuses on the implementation of primary care-based follow-up.

Purpose of the Study:

• To assess the reach of the RCT and identify implementation constructs for primary care-based prostate cancer follow-up.
• To understand patient, general practitioner (GP), and specialist perspectives on primary care follow-up.

Main Methods:

• Mixed-methods approach utilizing quantitative RCT reach data and qualitative interviews.
• The Consolidated Framework for Implementation Research guided the assessment.
• Thematic analysis was applied to interview transcripts from 15 patients, 10 GPs, and 8 specialists.

Main Results:

• 402 patients (67%) were recruited into the RCT, randomized equally to specialist or primary care follow-up.
• Patients and GPs perceived primary care follow-up as more accessible and personal.
• Identified challenges include the need for guideline implementation, enhanced communication, quality indicators, and GP compensation.

Conclusions:

• A significant proportion of patients and GPs are amenable to primary care-based prostate cancer follow-up within an RCT.
• Addressing identified challenges is crucial for a successful transition of prostate cancer follow-up to primary care if efficacy is demonstrated.