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Patient activation and patient-reported outcomes of men from a community pharmacy lifestyle intervention after prostate cancer treatment

Lemanska, Agnieszka; Poole, Karen; Manders, Ralph; Marshall, John; Nazar, Zachariah; Noble, Kevin; Saxton, John M.; Turner, Lauren; Warner, Gary; Griffin, Bruce A.; Faithfull, Sara


Agnieszka Lemanska

Karen Poole

Ralph Manders

John Marshall

Zachariah Nazar

Kevin Noble

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Professor John Saxton
Professor in Clinical Exercise Physiology and Acting Head of School

Lauren Turner

Gary Warner

Bruce A. Griffin

Sara Faithfull


Purpose: To report patient activation, which is the knowledge, skills, and confidence in self-managing health conditions, and patient-reported outcomes of men after prostate cancer treatment from a community pharmacy lifestyle intervention. Methods: The 3-month lifestyle intervention was delivered to 116 men in nine community pharmacies in the UK. Patient Activation Measure (PAM) was assessed at baseline, 3 and 6 months. Prostate cancer-related function and quality of life were assessed using the European Prostate Cancer Index Composite (EPIC-26) and EuroQOL 5-dimension 5-level (EQ5D-5L) questionnaires at baseline and 6 months. Lifestyle assessments included Mediterranean Diet Adherence Screener (MEDAS) at baseline, 3 and 6 months and Godin Leisure Time Exercise Questionnaire (GLTEQ) at baseline and 3 months. Results: PAM score increased from 62 [95% CI 59–65] at baseline to 66 [64–69] after the intervention (p = 0.001) and remained higher at 6 months (p = 0.008). Scores for all the EPIC-26 domains (urinary, bowel and hormonal) were high at both assessments, indicating good function (between 74 [70–78] and 89 [86–91]), except sexual domain, where scores were much lower (21 [17–25] at baseline, increasing to 24 [20–28] at 6 months (p = 0.012)). In EQ5D-5L, 3% of men [1–9] reported self-care problems, while 50% [41–60] reported pain and discomfort, and no significant changes over time. Men who received androgen deprivation therapy, compared with those who did not, reported higher (better) urinary incontinence scores (p < 0.001), but lower (worse) scores in the urinary irritative/obstructive (p = 0.003), bowel (p < 0.001) and hormonal (p < 0.001) domains. Poor sexual function was common across all age groups irrespective of prostate cancer treatment. Conclusions: The intervention led to significant improvements in patient activation, exercise and diet. Community pharmacy could deliver effective services to address sexual dysfunction, pain and discomfort which are common after prostate cancer.


Lemanska, A., Poole, K., Manders, R., Marshall, J., Nazar, Z., Noble, K., …Faithfull, S. (2022). Patient activation and patient-reported outcomes of men from a community pharmacy lifestyle intervention after prostate cancer treatment. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 30(1), 347-358.

Journal Article Type Article
Acceptance Date Jun 26, 2021
Online Publication Date Jul 21, 2021
Publication Date 2022
Deposit Date Jan 12, 2023
Publicly Available Date Jan 13, 2023
Journal Supportive Care in Cancer
Print ISSN 0941-4355
Electronic ISSN 1433-7339
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 30
Issue 1
Pages 347-358
Keywords Patient-reported outcomes (PROs); Prostate cancer; Lifestyle interventions; Community pharmacy
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© The Author(s) 2021.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit

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