MP83-19 REAL-WORLD USE OF EPIC FOR CLINICAL PRACTICE (EPIC-CP) TO ASSESS PATIENT-REPORTED PROSTATE CANCER QUALITY-OF-LIFE IN THE CLINICAL SETTING

Abstract

You have accessJournal of UrologyProstate Cancer: Localized IX1 Apr 2015MP83-19 REAL-WORLD USE OF EPIC FOR CLINICAL PRACTICE (EPIC-CP) TO ASSESS PATIENT-REPORTED PROSTATE CANCER QUALITY-OF-LIFE IN THE CLINICAL SETTING Peter Chang, Arie Carneiro, Ostap Dovirak, Kimberly Taylor, Catrina Crociani, Kyle McAnally, Andrew Percy, Martin G. Sanda, and Andrew A. Wagner Peter ChangPeter Chang More articles by this author , Arie CarneiroArie Carneiro More articles by this author , Ostap DovirakOstap Dovirak More articles by this author , Kimberly TaylorKimberly Taylor More articles by this author , Catrina CrocianiCatrina Crociani More articles by this author , Kyle McAnallyKyle McAnally More articles by this author , Andrew PercyAndrew Percy More articles by this author , Martin G. SandaMartin G. Sanda More articles by this author , and Andrew A. WagnerAndrew A. Wagner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1894AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer practitioners tend to underestimate the severity of patients' treatment-related side effects. We developed the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) to facilitate patient-reported health-related quality of life (HRQOL) assessment at the point-of-care (Chang P et al, J Urol Sep 2011). In this study, we sought to demonstrate the feasibility of EPIC-CP use in the routine clinical care of prostate cancer patients, and to compare longitudinal patient-reported and practitioner-reported prostate cancer outcomes. METHODS We reviewed practitioner- and patient-reported HRQOL outcomes in 482 patients who underwent radical prostatectomy at our institution from 2010 to 2014. All EPIC-CP questionnaires were administered and interpreted in routine clinical practice flow without research personnel. To assess practitioner-reported outcomes, we reviewed practitioners' documentation of patients' incontinence pad use (yes/no) and erections sufficient for intercourse (yes/no). We used the paired t-test and Wilcoxon signed-rank test to compare pre- and post-treatment EPIC-CP domain scores, and Fisher's exact test to compare patient-reported and practitioner-reported outcomes. We considered p-values < 0.05 statistically significant. RESULTS A total of 708 EPIC-CP questionnaires were completed. Mean urinary incontinence domain scores were significantly higher (worse) than baseline (0.6±0.2) at 3 months (3.1±2.3; p < 0.05) and 6 months (2.2±2.1; p < 0.05) post-treatment, and statistically returned to baseline at 12 months (1.6±1.7; p > 0.05). Patient-reported incontinence pad-free rates using EPIC-CP at 3, 6, and 12 months were 39%, 70%, and 76%, respectively, which were consistent with our practitioner-reported rates. Mean sexual domain scores were significantly worse than baseline (2.4±2.8) at 3 months (7.0±3.5), 6 months (5.7±3.1), and 12 months (5.9±3.3; p < 0.05 for all). Practitioners significantly overestimated the rate of functional erections compared to patients' EPIC-CP-reported rates at 3 months (18% vs 12%, p < 0.05) and 12 months (45% vs 23%, p < 0.05). Bowel and vitality/hormonal scores were unchanged, and urinary irritation/obstruction scores significantly improved after surgery. CONCLUSIONS EPIC-CP is feasible to use in the routine clinical care of prostate cancer patients without requiring research infrastructure. Using EPIC-CP in clinical practice may help practitioners objectively assess the severity of patients' post-treatment side effects. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1057 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Peter Chang More articles by this author Arie Carneiro More articles by this author Ostap Dovirak More articles by this author Kimberly Taylor More articles by this author Catrina Crociani More articles by this author Kyle McAnally More articles by this author Andrew Percy More articles by this author Martin G. Sanda More articles by this author Andrew A. Wagner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...