Operational scope and clinical practice profile of a nurse practitioner-led advanced prostate cancer clinic
A retrospective review from a Canadian cancer center
DOI:
https://doi.org/10.5489/cuaj.9570Keywords:
- advanced prostate cancer - hormone sensitive prostate cancer - prostate cancer treatment - practice patterns - novel hormonal agents - androgen receptor pathway inhibitors - hormonal therapy - Apalutamide - Darolutamide - Enzalutamide, care model, Health quality improvement, Efficiency, multidisciplinary care strategiesAbstract
Introduction: The use of androgen receptor pathway inhibitors (ARPIs) in advanced prostate cancer has improved survival outcomes, leading to increased survivorship followup demands and resource utilization. To address this, nurse practitioner-led prostate cancer clinics (NPPCCs) were implemented at a Canadian regional academic cancer center. We aimed to evaluate the scope and care delivery practices of NPPCCs managing patients on androgen deprivation therapy (ADT) and ARPI therapy.
Methods: A retrospective review of electronic medical records (EMR) was conducted at the Verspeeten Family Cancer Centre for patients ≥18 years old with confirmed prostate cancer managed in NP-led clinics from December 2018 to November 2024. Data included patient volumes/visits, as well as prescription, test, and referral orders within the EMR.
Results: A total of 531 patients were managed in the NPPCCs from December 2018 to November 2024. Annually, between two full-time NPs devoting one weekday to a NPPCC, there were 990 individual patient visits. In a one-year timeframe, each NP provided followup care to 167 and 162 patients, respectively. ARPI prescriptions were completed by NPs in 91.1% of patients. Across the 12-month evaluation period, 990 followup visits were delivered through NP-led clinics, representing a redistribution of longitudinal monitoring visits that would otherwise have occurred within physician clinics. Genetic testing was ordered in 35.3% of patients, and 39% received supportive medications for symptoms and toxicity management.
Conclusions: NPPCCs represent a feasible NP-led followup model for patients with prostate cancer receiving ADT and ARPIs. This descriptive evaluation characterizes the operational scope and clinical activities of the clinic, and provides a foundation for future studies evaluating safety, effectiveness, and economic impact.
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