PD11-01 ACCEPTANT AND COMMITMENT THERAPY TO INCREASE COMPLIANCE TO SEXUAL DYSFUNCTION TREATMENTS IN MEN WITH PROSTATE CANCER: 6- AND 12-MONTH DATA FROM A RANDOMIZED CONTROLLED TRIAL

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You have accessJournal of UrologyCME1 Apr 2023PD11-01 ACCEPTANT AND COMMITMENT THERAPY TO INCREASE COMPLIANCE TO SEXUAL DYSFUNCTION TREATMENTS IN MEN WITH PROSTATE CANCER: 6- AND 12-MONTH DATA FROM A RANDOMIZED CONTROLLED TRIAL Christian Nelson, Nassima Boukhalfa, Hayley Pessin, Nisha Mehta, Elizabeth Schofield, and John Mulhall Christian NelsonChristian Nelson More articles by this author , Nassima BoukhalfaNassima Boukhalfa More articles by this author , Hayley PessinHayley Pessin More articles by this author , Nisha MehtaNisha Mehta More articles by this author , Elizabeth SchofieldElizabeth Schofield More articles by this author , and John MulhallJohn Mulhall More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003251.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: For many men with prostate cancer, difficulty with sexual dysfunction, in particular erectile dysfunction (ED), can trigger a psychological process which leads to avoidance of utilizing sexual dysfunction treatments. This study tests a novel psychological intervention based on Acceptance and Commitment Therapy (ACT) concepts to help men utilize these treatments. METHODS: This ongoing study recruited men with prostate cancer starting intracavernosal injection therapy (ICIT) for the treatment of ED. The recruitment goal is N=220. Subjects are randomized to ICIT + ACT (ACT), which focuses on reducing avoidance, or ICIT + Enhanced Monitoring and Education (EME), which includes enhanced follow-up. Both groups receive ICIT plus 3 sessions (30-45 min) and 10 booster sessions (10 min). The interventions are delivered over the course of a year. Subjects are assessed at entry and every 6 months (m) for two years. The primary outcomes are the number of penile injections/week (verified by syringe count), and compliance (defined as ≥2 injections/week). Secondary outcomes assess psychosexual variables. Preliminary 6 m and 12 m data is presented. Since these are preliminary analyses, effect sizes (d) are reported for secondary variables (d=0.2, small effect; d=0.5, medium effect; d=0.8, large effect). RESULTS: To date, 191 subjects have been randomized; 112 have completed the 6m assessment (ACT n=57, EME n=55) and 97 completed the 12 m assessment (ACT n=48, EME n=49). Mean age at baseline was 60±7 years. At 6 m and 12 m, the ACT group utilized more injections/week vs. the EME group (6 m: median 1.8 vs. 1.2, p=0.01; 12 m: median 2.0 vs. 1.4, p=0.01) and were more compliant with ICI vs. the EME group (6 m: 65% vs. 35%, p=0.01, RR=1.86; 12 m: 79% vs. 41%, p=0.01, RR=1.93). At 6 m and 12 m, the ACT group reported greater: satisfaction with ED treatment (d=0.6) and overall sexual relationship (d=0.2). The ACT group also reported lower: sexual bother (d=0.2), prostate cancer treatment regret (d=0.3), negative psychological impact of cancer (d=0.3), and depressive symptoms (d=0.4). CONCLUSIONS: Preliminary analysis suggests ACT significantly increases ICI use. Data also indicate that ACT helps increase men’s satisfaction with injections and sexual relationship, while reducing sexual bother, prostate cancer treatment regret, the psychological impact of cancer, and depressive symptoms. Source of Funding: National Institutes of Health: R01 CA 190636 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e332 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christian Nelson More articles by this author Nassima Boukhalfa More articles by this author Hayley Pessin More articles by this author Nisha Mehta More articles by this author Elizabeth Schofield More articles by this author John Mulhall More articles by this author Expand All Advertisement PDF downloadLoading ...