Community-Based Practice Variations in Topical Treatment of Actinic Keratoses

Storer, Molly; Zhu, Zheng; Sokil, Monika; Ford, Margaret; Neugebauer, Romain; Asgari, Maryam M.

doi:10.1001/jamadermatol.2016.6251

Cited by 6 publications

(6 citation statements)

References 4 publications

(8 reference statements)

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“…Nowadays, choosing an appropriate and individualized intervention often largely depends on the knowledge, expertise, and preference of the practitioner as well as reimbursement status and may be insufficiently aligned with the individual desire of the patient [22,23]. In a recent qualitative study among physicians, cryosurgery was cited as the predominant therapy because other forms of therapy were little known or because there was uncertainty about their use [24].…”

Section: Discussionmentioning

confidence: 99%

Treatment Motivations and Expectations in Patients with Actinic Keratosis: A German-Wide Multicenter, Cross-Sectional Trial

Steeb

Wessely

Bubnoff

et al. 2020

JCM

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Patient-centered motives and expectations of the treatment of actinic keratoses (AK) have received little attention until now. Hence, we aimed to profile and cluster treatment motivations and expectations among patients with AK in a nationwide multicenter, cross-sectional study including patients from 14 German skin cancer centers. Patients were asked to complete a self-administered questionnaire. Treatment motives and expectations towards AK management were measured on a visual analogue scale from 1–10. Specific patient profiles were investigated with subgroup and correlation analysis. Overall, 403 patients were included. The highest motivation values were obtained for the items “avoid transition to invasive squamous cell carcinoma” (mean ± standard deviation; 8.98 ± 1.46), “AK are considered precancerous lesions” (8.72 ± 1.34) and “treating physician recommends treatment” (8.10 ± 2.37; p < 0.0001). The highest expectation values were observed for the items “effective lesion clearance” (8.36 ± 1.99), “safety” (8.20 ± 2.03) and “treatment-related costs are covered by health insurance” (8.00 ± 2.41; p < 0.0001). Patients aged ≥77 years and those with ≥7 lesions were identified at high risk of not undergoing any treatment due to intrinsic and extrinsic motivation deficits. Heat mapping of correlation analysis revealed four clusters with distinct motivation and expectation profiles. This study provides a patient-based heuristic tool for a personalized treatment decision in patients with AK.

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Section: Discussionmentioning

confidence: 99%

Treatment Motivations and Expectations in Patients with Actinic Keratosis: A German-Wide Multicenter, Cross-Sectional Trial

Steeb

Wessely

Bubnoff

et al. 2020

JCM

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“…19 Few studies have addressed the pattern of chemoprophylaxis prescription for KCs in real-world settings. 20,21 Fluorouracil prescription has previously been found to be more common in people aged 50-80 years, in men compared to women, for use on anatomical location away from the face, and prescribed by dermatologists. 21 Our findings suggest that risk scores developed using participant-reported data are associated with likelihood of chemoprophylaxis prescription and having procedures performed in a volunteer screening clinic.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have addressed the pattern of chemoprophylaxis prescription for KCs in real‐world settings 20,21 . Fluorouracil prescription has previously been found to be more common in people aged 50–80 years, in men compared to women, for use on anatomical location away from the face, and prescribed by dermatologists 21 .…”

Section: Discussionmentioning

confidence: 99%

Patterns and cost of care according to keratinocyte cancer risk stratification in a volunteer population screening clinic: Real‐world data from the TRoPICS study

et al. 2023

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BackgroundRisk prediction tools have been developed for keratinocyte cancers (KCs) to effectively categorize individuals with different levels of skin cancer burden. Few have been clinically validated nor routinely used in clinical settings.ObjectivesTo assess whether risk prediction tool categories associate with interventions including chemoprophylaxis for skin cancer, and health‐care costs in a dermatologist‐run screening clinic.MethodsAdult participants who presented to a walk‐in screening facility were invited to participate. A self‐completed KC risk prediction tool was used to classify participants into one of the five risk categories. Participants subsequently underwent full skin examination by a dermatologist. Dermatological interventions and skin cancer‐related medical prescriptions were documented. Total health‐care costs, both to the health‐care system and patients were evaluated.ResultsOf the 507 participants recruited, 5‐fluorouracil cream and nicotinamide were more frequently prescribed in the higher risk groups as chemoprophylaxis (p < 0.005). A significant association with high predicted risk was also observed in the use of cryotherapy and curettage and cautery (p < 0.05). The average health‐care costs associated with a skin check visit increased from $90 ± 37 (standard deviation) in the lowest risk group to $149 ± 97 in the highest risk group (p < 0.0001).ConclusionsWe observed a positive association between higher predicted risk of skin cancer and the prescription of chemoprophylaxis and health‐care costs involved with opportunistic community skin cancer screening. A clinical use of risk stratification may be to provide an opportunity for clinicians to discuss skin cancer prevention and chemoprophylaxis with individual patients.

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“…They are common with more than 580,000 people occurring in the United States every year, which caused at least 100 million dollars every year. 1 The pathogenesis is closely related to long-term exposure to ultraviolet rays. 2 Thus, they are prone to arise on sun-exposed areas and bring cosmetic problems.…”

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confidence: 99%

Efficacy and Safety of Photodynamic Therapy for the Treatment of Actinic Keratoses: A Meta-Analysis Update of Randomized Controlled Trials

Luo

Jiang

et al. 2023

Dermatol Surg

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Community-Based Practice Variations in Topical Treatment of Actinic Keratoses

Cited by 6 publications

References 4 publications

Treatment Motivations and Expectations in Patients with Actinic Keratosis: A German-Wide Multicenter, Cross-Sectional Trial

Treatment Motivations and Expectations in Patients with Actinic Keratosis: A German-Wide Multicenter, Cross-Sectional Trial

Patterns and cost of care according to keratinocyte cancer risk stratification in a volunteer population screening clinic: Real‐world data from the TRoPICS study

Efficacy and Safety of Photodynamic Therapy for the Treatment of Actinic Keratoses: A Meta-Analysis Update of Randomized Controlled Trials

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