Title: Transforming management of advanced prostate cancer: Increasing clinical productivity and capacity and empowering men through digital health
Funder: Department of Health and Social Care

Abstract: Prostate cancer (PC) is the commonest male cancer worldwide. Each year 10,000 UK men are diagnosed with advanced disease and incidence has increased by 41% since the early 1990s. Hormonal therapy and early chemotherapy has led to much improved patient outcomes and survival has been further extended (to 3-5 years) for patients even with advanced disease, by additional tablet-based treatments (e.g. enzalutamide or abiraterone). During much of this time, PC behaves like a chronic disease, requiring stable medication and regular monitoring. These undoubted patient benefits come at a cost. They have led to increased demands, placing major strains on the health service which is approaching a capacity crisis. The personal and financial cost to men and their families is also substantial requiring more frequent appointments for blood tests, toxicity monitoring and up to 15 clinic visits per year. These issues have encouraged exploration of alternative strategies to deliver care in line with the 2019 NHS long-term plan, which aims to reduce outpatient attendances by up to one-third within 5 years. Itecho Health has developed an innovative digital platform (AscelusTM) which can potentially address this demand, especially when patients are on oral therapy, by reducing the requirement to attend hospital whilst maintaining full communication between patient, GP and the hospital. The AscelusTM digital platform integrates with NHS IT systems and allows patients to be securely linked via their smartphone or other device with their existing clinical team, allowing face-to-face outpatient appointments to be replaced by a convenient mobile interaction. Patients can record symptoms, receive clinical advice and test results, check for medication interactions and book appointments via their device. In this project, Itecho has linked with partners at Weston Park Hospital, Sheffield and the Universities of Sheffield and Leeds, in order to assess the AscelusTM in men with PC commencing abiraterone or enzalutamide treatment through seven work packages, including patent focus groups, a clinical feasibility and safety study and an economic analysis. Patient and public involvement and engagement has been embedded in our approach and will continue throughout the project. The uniqueness of this project is that it is true co-design between industry, clinicians, academia and the end-users. We will robustly test the digital tool using a simulation space, to ensure that patients maintain a sense of empowerment and connection to hospital staff, whilst maximising time away from hospitals and enjoying life. This award will enable platform , clinical feasibility/acceptability studies and economic modelling. At project completion, we will have the necessary information to move seamlessly to a larger multi-site evaluation study to pave the way for wider uptake in the NHS, potentially improving patient experience, freeing up clinician time for more complex cases and with economic benefits for the NHS.

Lay abstract: Prostate cancer (PC) is the commonest male cancer worldwide. Each year 10,000 UK men are diagnosed with advanced disease and incidence has increased by 41% since the early 1990s. Hormonal therapy and early chemotherapy has led to much improved patient outcomes and survival has been further extended (to 3-5 years) for patients even with advanced disease, by additional tablet-based treatments (e.g. enzalutamide or abiraterone). During much of this time, PC behaves like a chronic disease, requiring stable medication and regular monitoring. These undoubted patient benefits come at a cost. They have led to increased demands, placing major strains on the health service which is approaching a capacity crisis. The personal and financial cost to men and their families is also substantial requiring more frequent appointments for blood tests, toxicity monitoring and up to 15 clinic visits per year. These issues have encouraged exploration of alternative strategies to deliver care in line with the 2019 NHS long-term plan, which aims to reduce outpatient attendances by up to one-third within 5 years. Itecho Health has developed an innovative digital platform (AscelusTM) which can potentially address this demand, especially when patients are on oral therapy, by reducing the requirement to attend hospital whilst maintaining full communication between patient, GP and the hospital. The AscelusTM digital platform integrates with NHS IT systems and allows patients to be securely linked via their smartphone or other device with their existing clinical team, allowing face-to-face outpatient appointments to be replaced by a convenient mobile interaction. Patients can record symptoms, receive clinical advice and test results, check for medication interactions and book appointments via their device. In this project, Itecho has linked with partners at Weston Park Hospital, Sheffield and the Universities of Sheffield and Leeds, in order to assess the AscelusTM in men with PC commencing abiraterone or enzalutamide treatment through seven work packages, including patent focus groups, a clinical feasibility and safety study and an economic analysis. Patient and public involvement and engagement has been embedded in our approach and will continue throughout the project. The uniqueness of this project is that it is true co-design between industry, clinicians, academia and the end-users. We will robustly test the digital tool using a simulation space, to ensure that patients maintain a sense of empowerment and connection to hospital staff, whilst maximising time away from hospitals and enjoying life. This award will enable platform , clinical feasibility/acceptability studies and economic modelling. At project completion, we will have the necessary information to move seamlessly to a larger multi-site evaluation study to pave the way for wider uptake in the NHS, potentially improving patient experience, freeing up clinician time for more complex cases and with economic benefits for the NHS.

Research activity codes: 6.3 MEDICAL DEVICES
Health categories: CANCER AND NEOPLASMS