Prostate Cancer Supportive Care (PCSC) program: An alternative to consolidated framework for implementation research (CFIR) model.

Abstract

346 Background: The CFIR model is one approach to implementing supportive care services. It requires extensive resources, staff training, and reliance on infrastructure. In contrast, the PCSC Program grew organically based on knowledge of patient-expressed needs. Rather than tailoring services to individuals, the PCSC Program offers a menu of services that the patient can choose from with the help of a program coordinator. Methods: We compared the implementation considerations for CFIR (1) to those of the PCSC Program. Results: Patient Needs Assessment & Staffing: CFIR assesses needs at diagnosis using specific tools in the EHR and recommends a care plan formulated by a multidisciplinary team. In contrast, PCSC empowers patients to self-select services from eight modules (see table below) based on their needs after registration, whether at diagnosis or beyond. This flexibility allows the program to operate efficiently, freeing up clinician time for delivering group education sessions and clinic appointments. Resource Management and follow-up: CFIR identifies community resources with a multidisciplinary team. This may require referrals and clinic-specific communication. This approach may lead to inconsistencies and variation in patient experience. In contrast, PCSC provides all services at a single site that is familiar to many patients as it is across from the urology clinic. Clinic visits are in person or virtual, allowing access to all patients across the province. This model eliminates the need for extensive documentation, and the quality of the services is controlled centrally. Since there is transparency on available services from the outset, patients may return as needed, negating the need for individualized formal follow-up assessments. Sustainability and Impact: While CFIR is process-driven, PCSC’s model has supported over 5,288 patients and their families, free of charge, with $3.25 million in philanthropic support over 11 years in addition to grants and government funding, underscoring the community's trust in the program's efficacy and value. Conclusions: CFIR is a structured and resource-intensive approach that focuses on the individual patient. The PCSC Program presents patients with a menu of services known to be of importance to this population and offers a flexible, patient-driven approach. The longevity of the PCSC Program and the patient satisfaction responses suggest that this is an alternative model for delivering supportive care. 1. Stout et al JCO Oncol Pract 20:1173-1181. Attendance for 5288 registrants from 2013 to 09/2024. Modules Attendees 2013-9/2024, n Introduction to PC and Primary Treatment Options 1994 Managing Sexual Function and Intimacy 2461 Management of side effects of ADT 809 Pelvic Floor Physiotherapy for Incontinence 1890 Counselling 852 Metastatic Disease Management 162 Nutrition 1527 Exercise 1336