MP73-10 CARE PATHWAY IMPLEMENTATION INFLUENCES CONVERSION TO SURGICAL THERAPY IN BPH PATIENTS Article Swipe

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Andrew Trainer , Euclid DeSouza , John Horgan , Bruce Lundak , S. Bolte , C. Brent Wakefield , Andrew Arther ·

YOU? · · 2018 · Open Access · · DOI: https://doi.org/10.1016/j.juro.2018.02.2374

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II1 Apr 2018MP73-10 CARE PATHWAY IMPLEMENTATION INFLUENCES CONVERSION TO SURGICAL THERAPY IN BPH PATIENTS Andrew Trainer, Euclid deSouza, John Horgan, Bruce Lundak, Stefanie Bolte, C. Brent Wakefield, and Andrew Arther Andrew TrainerAndrew Trainer More articles by this author , Euclid deSouzaEuclid deSouza More articles by this author , John HorganJohn Horgan More articles by this author , Bruce LundakBruce Lundak More articles by this author , Stefanie BolteStefanie Bolte More articles by this author , C. Brent WakefieldC. Brent Wakefield More articles by this author , and Andrew ArtherAndrew Arther More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2374AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Benign Prostatic Hyperplasia (BPH) is a common, urological condition impacting quality of life. Outcomes may be influenced by patient education and engagement. This study aimed to determine if a patient navigation care pathway that includes education of treatment options such as medical therapy, minimally invasive approaches, and surgical intervention may impact time to conversion to invasive treatment. METHODS Three cohorts of patients were enrolled in the study that included retrospective, crossover, and prospective data. The retrospective patients (group 1, N=96) were the control group who had an initial patient encounter with the site between 1/2015 and 7/2016 and were not exposed to the care pathway during the study. The prospective patients (group 2, N=55) had an initial patient encounter between 6/2017 and 10/2017 after care pathway implementation at the site. The crossover patients (group 3, N=95) had an initial patient encounter prior to care pathway implementation (10/2011 through 6/2017) and a subsequent care pathway encounter. The care pathway encounter involved a comprehensive symptom evaluation, patient goal discussion, and education on treatment options. Further, care pathway patients agreed to clinical follow-up including collection of IPSS data over 8-10 weeks (via phone or office visit). Changes in IPSS prompted further discussions on therapy options. Time to conversion to surgical therapy was assessed for each cohort and incidence rate was assessed with a chi-square test of association. RESULTS There were no statistically significant differences between cohorts in terms of baseline IPSS (20.7, 18.6, 19.5) for groups 1-3, respectively (p>0.1). Time to conversion to surgical therapy differed between group 1 (0.2 conversions/patient-year) and group 2 (0.6 conversions/patient-year). Chi-square test of association indicates that group 2 converted to surgical therapy significantly faster than group 1 (p=0.03). The patients in group 3 were monitored by the investigators with medications/active surveillance for an average of 18 months prior to exposure to the care pathway. After exposure to the pathway, group 3 demonstrated 1 conversion/patient-year, similar to group 2 and significantly more than group 1 (p<0.01). CONCLUSIONS This study suggests that time to conversion to surgical therapy for BPH can be influenced by increased navigator communication and education. With a growing number of minimally-invasive treatment choices, practice outreach and education can help patients achieve their goals. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e994-e995 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Andrew Trainer More articles by this author Euclid deSouza More articles by this author John Horgan More articles by this author Bruce Lundak More articles by this author Stefanie Bolte More articles by this author C. Brent Wakefield More articles by this author Andrew Arther More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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Medicine Trainer Retrospective cohort study Care pathway General surgery Prospective cohort study Surgery Health care Economics Economic growth Programming language Computer science

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Landing Page: https://doi.org/10.1016/j.juro.2018.02.2374
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DOI: https://doi.org/10.1016/j.juro.2018.02.2374

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Title: MP73-10 CARE PATHWAY IMPLEMENTATION INFLUENCES CONVERSION TO SURGICAL THERAPY IN BPH PATIENTS

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Publication year: 2018

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Authors: Andrew Trainer, Euclid DeSouza, John Horgan, Bruce Lundak, S. Bolte, C. Brent Wakefield, Andrew Arther

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Landing page: https://doi.org/10.1016/j.juro.2018.02.2374

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Concepts: Medicine, Trainer, Retrospective cohort study, Care pathway, General surgery, Prospective cohort study, Surgery, Health care, Economics, Economic growth, Programming language, Computer science

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abstract_inverted_index.WakefieldC.	89
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abstract_inverted_index.UrologyBenign	4
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abstract_inverted_index.retrospective,	190
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abstract_inverted_index.ShareFacebookTwitterLinked	116
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