PMID- 37672332
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230923
IS  - 2369-1999 (Print)
IS  - 2369-1999 (Electronic)
IS  - 2369-1999 (Linking)
VI  - 9
DP  - 2023 Sep 6
TI  - Effects of Web-Based and Mobile Self-Care Support in Addition to Standard Care in 
      Patients After Radical Prostatectomy: Randomized Controlled Trial.
PG  - e44320
LID - 10.2196/44320 [doi]
LID - e44320
AB  - BACKGROUND: Prostate cancer is a common form of cancer that is often treated with 
      radical prostatectomy, which can leave patients with urinary incontinence and 
      sexual dysfunction. Self-care (pelvic floor muscle exercises and physical 
      activity) is recommended to reduce the side effects. As more and more men are 
      living in the aftermath of treatment, effective rehabilitation support is 
      warranted. Digital self-care support has the potential to improve patient 
      outcomes, but it has rarely been evaluated longitudinally in randomized 
      controlled trials. Therefore, we developed and evaluated the effects of digital 
      self-care support (electronic Patient Activation in Treatment at Home [ePATH]) on 
      prostate-specific symptoms. OBJECTIVE: This study aimed to investigate the 
      effects of web-based and mobile self-care support on urinary continence, sexual 
      function, and self-care, compared with standard care, at 1, 3, 6, and 12 months 
      after radical prostatectomy. METHODS: A multicenter randomized controlled trial 
      with 2 study arms was conducted, with the longitudinal effects of additional 
      digital self-care support (ePATH) compared with those of standard care alone. 
      ePATH was designed based on the self-determination theory to strengthen patients' 
      activation in self-care through nurse-assisted individualized modules. Men 
      planned for radical prostatectomy at 3 county hospitals in southern Sweden were 
      included offline and randomly assigned to the intervention or control group. The 
      effects of ePATH were evaluated for 1 year after surgery using self-assessed 
      questionnaires. Linear mixed models and ordinal regression analyses were 
      performed. RESULTS: This study included 170 men (85 in each group) from January 
      2018 to December 2019. The participants in the intervention and control groups 
      did not differ in their demographic characteristics. In the intervention group, 
      64% (53/83) of the participants used ePATH, but the use declined over time. The 
      linear mixed model showed no substantial differences between the groups in 
      urinary continence (beta=-5.60; P=.09; 95% CI -12.15 to -0.96) or sexual function 
      (beta=-.12; P=.97; 95% CI -7.05 to -6.81). Participants in the intervention and 
      control groups did not differ in physical activity (odds ratio 1.16, 95% CI 
      0.71-1.89; P=.57) or pelvic floor muscle exercises (odds ratio 1.51, 95% CI 
      0.86-2.66; P=.15). CONCLUSIONS: ePATH did not affect postoperative side effects 
      or self-care but reflected how this support may work in typical clinical 
      conditions. To complement standard rehabilitation, digital self-care support must 
      be adapted to the context and individual preferences for use and effect. TRIAL 
      REGISTRATION: ISRCTN Registry ISRCTN18055968; 
      https://www.isrctn.com/ISRCTN18055968. INTERNATIONAL REGISTERED REPORT IDENTIFIER 
      (IRRID): RR2-10.2196/11625.
CI  - (c)Camilla Wennerberg, Amanda Hellstrom, Kristina Schildmeijer, Mirjam Ekstedt. 
      Originally published in JMIR Cancer (https://cancer.jmir.org), 06.09.2023.
FAU - Wennerberg, Camilla
AU  - Wennerberg C
AUID- ORCID: 0000-0002-7158-2883
AD  - Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
AD  - Department of Surgery, Region Kalmar County, Kalmar, Sweden.
FAU - Hellstrom, Amanda
AU  - Hellstrom A
AUID- ORCID: 0000-0001-8398-9552
AD  - Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
FAU - Schildmeijer, Kristina
AU  - Schildmeijer K
AUID- ORCID: 0000-0002-0895-674X
AD  - Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
FAU - Ekstedt, Mirjam
AU  - Ekstedt M
AUID- ORCID: 0000-0002-4108-391X
AD  - Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
AD  - Department of Learning, Management, Informatics and Ethics, Karolinska 
      Institutet, Stockholm, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20230906
PL  - Canada
TA  - JMIR Cancer
JT  - JMIR cancer
JID - 101666844
PMC - PMC10512115
OTO - NOTNLM
OT  - eHealth
OT  - linear mixed model
OT  - mHealth
OT  - mobile health
OT  - pelvic exercise
OT  - physical activity
OT  - prostate cancer
OT  - prostatic neoplasms
OT  - radical prostatectomy
OT  - randomized controlled trial
OT  - self-care
OT  - sexual dysfunction
OT  - telemedicine
OT  - urinary incontinence
OT  - web-based
COIS- Conflicts of Interest: None declared.
EDAT- 2023/09/06 12:42
MHDA- 2023/09/06 12:43
PMCR- 2023/09/06
CRDT- 2023/09/06 11:54
PHST- 2022/11/16 00:00 [received]
PHST- 2023/07/21 00:00 [accepted]
PHST- 2023/06/09 00:00 [revised]
PHST- 2023/09/06 12:43 [medline]
PHST- 2023/09/06 12:42 [pubmed]
PHST- 2023/09/06 11:54 [entrez]
PHST- 2023/09/06 00:00 [pmc-release]
AID - v9i1e44320 [pii]
AID - 10.2196/44320 [doi]
PST - epublish
SO  - JMIR Cancer. 2023 Sep 6;9:e44320. doi: 10.2196/44320.