A study using an online assessment tool for prostate cancer (ICARE-P)

The study team found the CHAT-P tool was acceptable and thought to be of benefit by both the men and their healthcare team. 

About this study
This study was in 2 stages. 

In the 1st stage the researchers interviewed 10 men with prostate cancer and 8 healthcare professionals such as Clinical Nurse Specialist, Practice Nurses and General Practitioners (GP). The team explored what they thought about CHAT-P before using it. 

The 2nd stage was 9 to 12 months after CHAT-P was used. In this stage the researchers interviewed 7 men and 4 healthcare professionals to find out what were the barriers to using CHAT-P and what encouraged its use. 

Results of stage 1
The team looked at what the men and the healthcare professionals thought might be the benefits to using CHAT-P. 

The men thought the benefits would be:

• using CHAT-P to give order to their concerns from the most important to the least important 
• giving the healthcare professionals a better more complete picture of their health and so saving them time
• a way to gain information and practical advice about prostate cancer  

They also felt it would be a benefit to men whose skills of using the internet was low. 

The healthcare professionals thought the benefits would be:

• helping the men to get involved with their care
• helping the men to talk about their concerns
• a way to start conversations and keeping focus

The healthcare professionals were keen to start using CHAT-P. As they saw it as a way of sharing the care between them and the men. They also felt that CHAT-P would give a better insight into the specialised care each man needs. 

The team then looked at what the men and healthcare professionals thought might be barriers to using CHAT-P. 

The men and the healthcare professionals thought the barriers might be:

• age of the man
• language difficulties because English was not their first language 
• poor eyesight making it difficult to see the computer screen
• decreased ability to concentrate due to pain
• computer skills and access to a computer
• the willingness or capability of deciding about your own health

The health professionals thought the barriers might also include:

• their current lack of specialist knowledge about prostate cancer as a non specialist 
• the idea that men would rather be seen by a specialist 
• their level of involvement relying on how much guidance they received from the specialist

Nurses spoke of a desire to increase their level of knowledge about prostate cancer. But a lack of money and related training was a barrier to this. 

One GP and some of the men feared that losing the face to face talks could cause problems such as concerns and problems not being reported properly. 

Results of stage 2
After using CHAT-P the men and healthcare professionals said there were benefits to using it. 

The men valued that they were more involved in their own care. And felt that CHAT-P encouraged them to reflect more on their own needs. 

The healthcare professionals felt that CHAT-P helped them to better relate to the men. 

Practice nurses felt more supported by having direct access to the Clinical Nurse Specialist in the hospital. And this made it easier for them to refer the men when necessary. The Clinical Nurse Specialists also valued the better communication from using CHAT-P.

The researchers then asked about the barriers to using CHAT-P. For the men it was the reporting of symptoms. Those who felt free of symptoms or had accepted their symptoms found it difficult to complete questions. 

Some felt it was a reminder of their cancer. And said that they preferred not think about their cancer because they worried about how it would affect them and their family. 

Others felt it wasn’t relevant to them as their cancer was diagnosed many years ago. 

For the healthcare professionals the barriers were about the speed of the connection and logging on to CHAT-P. 

Conclusion
The study team concluded CHAT-P was acceptable to both men and the healthcare professionals. And that they also found it helpful to use especially for men who have just been diagnosed with prostate cancer. 

Researchers say these findings will help them when they set up further trials using CHAT-P. And help CHAT-P to be adopted as part of the routine practice when caring for men with prostate cancer. 

Many speciality urology services in the NHS will start to use CHART-P as part of their care. 

Researchers are developing a similar tool for people with bladder cancer. This is CHART-B. 

Where this information comes from    
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed ) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.