Assessing quality and safety of an advanced practice provider-led active surveillance clinic for men with prostate cancer Journal Article


Authors: Clements, M. B.; Lin, X.; Gmelich, C.; Vertosick, E. A.; Vickers, A. J.; Manasia, M. K.; Wolchasty, N. C.; Scardino, P. T.; Eastham, J. A.; Laudone, V. P.; Touijer, K. A.; Ehdaie, B.
Article Title: Assessing quality and safety of an advanced practice provider-led active surveillance clinic for men with prostate cancer
Abstract: Introduction: We implemented an advanced practice provider (APP)-led clinic to aid in managing the growing population of men on active surveillance (AS) for prostate cancer. Our objective was to evaluate the quality and safety of an established APP-led AS clinic by comparing outcomes with urologist-led biopsies, defined in terms of adherence to scheduled visits and biopsy complications. Methods: We performed a retrospective review of 2,341 consecutive patients treated in an AS clinic at a high-volume referral center between 2000 and 2019. We examined the rate of no-show or same-day cancellation of visits for APPs versus urologists and compared the risk of biopsy complications between these providers. Generalized estimating equations were used to account for repeated visits and biopsies. Results: There were significantly more no-shows at APP visits (OR 1.40, 95% CI 1.16-1.70; p <0.001); however, this only amounted to 1 no-show every 41 visits. There was no evidence of increased biopsy complications with APPs (OR 0.37, 95% CI 0.05-2.49; p=0.3). Patients were not prospectively assigned to APP or urologist management; therefore, unmeasured patient differences could bias our results. Conclusions: We demonstrated that in an established APP-led AS clinic at a high-volume center, APPs achieved acceptable patient adherence to scheduled visits and biopsy complications. Because patients were not continuously managed by one type of provider, further prospective studies are needed to establish equivalent pathological outcomes in APP-managed AS.
Keywords: biopsy; prostatic neoplasms; nurse practitioners; physician assistants; watchful; waiting; nurse-practitioner
Journal Title: Urology Practice
Volume: 8
Issue: 5
ISSN: 2352-0779
Publisher: Lippincott Williams & Wilkins  
Date Published: 2021-09-01
Start Page: 535
End Page: 540
Language: English
ACCESSION: WOS:000711775500001
DOI: 10.1097/upj.0000000000000249
PROVIDER: wos
PMCID: PMC9555125
PUBMED: 36238352
Notes: Article -- Source: Wos
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Vincent Laudone
    137 Laudone
  2. Peter T Scardino
    671 Scardino
  3. Karim Abdelkrim Touijer
    259 Touijer
  4. Andrew J Vickers
    882 Vickers
  5. Behfar Ehdaie
    174 Ehdaie
  6. James Eastham
    538 Eastham
  7. Emily Vertosick
    135 Vertosick
  8. Xin Lin
    7 Lin