Patterns and predictors of attendance at a comprehensive, multi-disciplinary supportive care program for men with prostate cancer and their partners.

Abstract

6 Background: Men diagnosed with prostate cancer (PC) face treatment-related sequlae that affect their health and quality of life. The Vancouver Prostate Centre’s (VPCs) Prostate Cancer Supportive Care (PCSC) Program is a comprehensive program for men and their partners that aims to address these challenges. Our objective is to examine registration rates, and the timing/intensity of follow-up with the program, and to explore clinical/sociodemographic factors associated with participation and non-participation. Methods: We used charts for all men who registered with the PCSC program (“registrants”), and a random sample of men who sought PC-related care at the VPC but did not register with the program (“non-registrants”) from Jan 2013-Dec 2016. Registrants were classified as “attenders” (came to PCSC information session/clinic visit), or “non-attenders” (did not attend). We used multivariate logistic regression to quantify the effect of diagnostic, treatment and sociodemographic characteristics on registration. We produced an unadjusted Kaplan-Meier estimator to assess the probability of program attendance over the disease trajectory for those who registered. We used Cox proportional hazards regression to examine impact of the same factors on timing of program participation and a binary logistic model to examine which factors impact program attendance. Results: Preliminary results suggest that 17% of the men who enroll in the program do not subsequently use any services. Program participation continues for more than four years after diagnosis and varies based on Gleason score (Chi Square (CS) = 20.9, p = 0.01), risk score (CS = 11.5, p = 0.02), and clinical T stage (CS = 14.0, p < 0.001). We found no difference participation by age, age at diagnosis, travel distance to clinic or treatment modality. Complete results will be available at the time of presentation. Conclusions: One in six men who register for supportive care do not end up using any despite the program being free of charge. Drivers of non-participation appear to be clinical, with lower risk patients being more likely to chose not to participate, though further investigation is required.