Pd62-08 the Man Van Project: Second Phase Interim Results

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety III (PD62)1 May 2024PD62-08 THE MAN VAN PROJECT: SECOND PHASE INTERIM RESULTS Masood Moghul, Fionnuala Croft, Fiona Mutch, Elisabeth Westaway, Netty Kinsella, Declan Cahill, and Nicholas D. James Masood MoghulMasood Moghul , Fionnuala CroftFionnuala Croft , Fiona MutchFiona Mutch , Elisabeth WestawayElisabeth Westaway , Netty KinsellaNetty Kinsella , Declan CahillDeclan Cahill , and Nicholas D. JamesNicholas D. James View All Author Informationhttps://doi.org/10.1097/01.JU.0001008656.89655.67.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Early intervention is potentially lifesaving in prostate cancer. The Man Van project ran a successful pilot designed to address health inequalities that affect prostate cancer with a highly novel community-based targeting of high-risk groups on a mobile unit. Following the pilot the project was redesigned to increase efficiency and throughput of patients and relaunched as a nurse-led service. METHODS: A bespoke mobile clinical unit was moved to community-based locations in areas of high deprivation indices in London, UK, with targeted invitations to high-risk men via primary care. Men were offered prostate-specific antigen test counselling and a general health check including: blood pressure, body mass index and an HbA1c test for diabetes. Patient throughput was increased by reducing appointment times from 30 to 15 minutes, with capacity for over 100 patients per week. Efficiency was increased by developing an online registration system with pre-attendance questionnaires. Multiple text message reminders were utilised to reduce non-attendance rates. RESULTS: Between January 2023 and June 2023, 1431 men booked to be seen at Man Van clinics. 1234 men attended with a 10% non-attendance rate (previously 24%). The median age of attendees was 59 years, range 39-97. 64% of attendees were white and 11% had Black ethnicity. 108 referrals for elevated PSA were made on cancer pathways. The median PSA was 5.95g/L, (range 2.61-167g/L). 91 patients had MRI scans of the prostate of which 58% scored PIRADS 1 or 2, 12% were PIRADS 3 and 30% were either PIRADS 4 or 5. 45 patients underwent prostate biopsies with 34 prostate cancers diagnosed (76% of biopsies) yielding an overall diagnostic rate of 2.8%. 31 of these cancers (91%) were clinically significant (Gleason 3+4 >5% or higher grade). No prostate cancers were metastatic at presentation, with only one being T4. The overall diagnostic rate of clinically significant disease was 2.5%. Thus far 12 patients (35%) have been managed on active surveillance, 12 patients with radical robotic prostatectomy and 10 patients with radiotherapy. 37 patients were referred for haematuria investigations with 2 bladder cancers diagnosed. Both of these were high-grade and one was metastatic at presentation. CONCLUSIONS: The Man Van project has evolved into a more efficient service utilising online registration systems and developing into a nurse-led service. By combining patient targeting through primary care with awareness raising through local community groups we have maintained participation rates of ethnic minorities. Multiple text message reminders have reduced our non-attendance rates. Of relevance is our diagnostic rate, with the overwhelming majority of cancers found to be Gleason 3+4 (>5%) or a higher grade. The difference between this rate and similar large scale screening studies suggests that our strategy of targeting high-risk men does skew the case mix towards higher-risk disease. Source of Funding: NHS England © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1288 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Masood Moghul More articles by this author Fionnuala Croft More articles by this author Fiona Mutch More articles by this author Elisabeth Westaway More articles by this author Netty Kinsella More articles by this author Declan Cahill More articles by this author Nicholas D. James More articles by this author Expand All Advertisement PDF downloadLoading ...