160 Canadian TrueNTH Sexual Health and Rehabilitation eClinic (SHAReClinic) for Prostate Cancer Patients: Results of a Feasibility Study

Abstract

Introduction: Sexual dysfunction (SD) after prostate cancer (PC) has a significant negative impact on a patient’s health-related quality of life. The TrueNTH Sexual Health and Rehabilitation eClinic (SHAReClinic) is a Canadian online intervention for patients/couples seeking treatment for sexual dysfunction after treatment for localized PC. The SHAReClinic intervention involves six online clinic visits; one pretreatment and five follow-up visits over a one-year period post PC treatment. Components of SHAReClinic include tailored and structured educational modules, personalized support via an online sexual health counsellor, a virtual library, and tracking and feedback mechanisms for participants. Objective: The objectives of this study are: 1) to determine the acceptability, and 2) to inform the effectiveness of an online, biopsychosocial intervention (SHAReClinic) in treating sexual dysfunction and supporting intimacy maintenance following localized PC treatment. Method: This single-arm, prospective feasibility study recruited participants from six healthcare institutions across Canada to enroll in SHAReClinic. Website usage and analytics were analyzed at the end of the study to assess intervention acceptability. Questionnaires were completed at pre-treatment, 6 weeks, 6 months, and 12 months post treatment to inform the intervention effectiveness. Outcome measures for sexual function included the Sexual Health Inventory for Men (SHIM), the Patient-Reported Outcome Measurement Information System (PROMIS)- Interest in Sexual Activity and Sexual Activities, and the sexual health questions of the Expanded Prostate Index Composite (EPIC). Sexual distress and relationship intimacy were measured using the Sexual Distress Scale (SDS) and the Miller Social Intimacy Scale (MSIS) questionnaires respectively. Descriptive statistics were used to summarize the data. Results: Sixty-five patients were enrolled in SHAReClinic. Website analytics revealed that 71% completed all of the intervention’s educational modules and questionnaires, with an additional 10% completed more than half of the intervention. 5,083 views of the educational modules were made along with 654 views of the health library items. Over 1,500 messages were exchanged between participants and their sexual health counsellors. At 12 months, SHAReClinic received an overall average participant rating of 4.1 out of 5 on a single item satisfaction measure. At 12 months post PC treatment 35.7% reported mild-to-moderate or better erectile dysfunction, defined as a SHIM score of 12 or higher. As measured by the EPIC, 26.1% of patients reported having erections firm enough for penetration. On the PROMIS, 33.3% of participants reported having at least one penetrative sexual activity in the past 30 days. The number of patients using pro-erectile medication steadily increased from 24.1% at 6 weeks after treatment to 50.0% at 12 months. Additionally, patient intimacy and sexual distress levels remained unchanged over time (MSIS and SDS, respectively). Conclusion: Our results support that SHAReClinic is highly acceptable to participants as defined by intervention adherence and engagement. Similarly, SHAReClinic demonstrates promise for being a feasible, and potentially resource efficient approach to effectively improving the sexual wellbeing of patients after PC treatment. Disclosure: Work supported by industry: yes, by Movember Foundation and Prostate Cancer Canada.