Experiences of Patient-Led Surveillance, Including Patient-Performed Teledermoscopy, in the MEL-SELF Pilot Randomized Controlled Trial: Qualitative Interview Study
BackgroundCurrent clinician-led melanoma surveillance models require frequent routinely scheduled clinic visits, with associated travel, cost, and time burden for patients. Patient-led surveillance is a new model of follow-up care that could reduce health care use such as cli...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2022-07-01
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| Series: | JMIR Dermatology |
| Online Access: | https://derma.jmir.org/2022/3/e35916 |
| _version_ | 1797328364080463872 |
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| author | Dorothy Drabarek Emily Habgood Monika Janda Jolyn Hersch Deonna Ackermann Don Low Cynthia Low Rachael L Morton Mbathio Dieng Anne E Cust Adelaide Morgan Elloise Smith Katy L J Bell |
| author_facet | Dorothy Drabarek Emily Habgood Monika Janda Jolyn Hersch Deonna Ackermann Don Low Cynthia Low Rachael L Morton Mbathio Dieng Anne E Cust Adelaide Morgan Elloise Smith Katy L J Bell |
| author_sort | Dorothy Drabarek |
| collection | DOAJ |
| description |
BackgroundCurrent clinician-led melanoma surveillance models require frequent routinely scheduled clinic visits, with associated travel, cost, and time burden for patients. Patient-led surveillance is a new model of follow-up care that could reduce health care use such as clinic visits and medical procedures and their associated costs, increase access to care, and promote early diagnosis of a subsequent new melanoma after treatment of a primary melanoma. Understanding patient experiences may allow improvements in implementation.
ObjectiveThis study aims to explore patients’ experiences and perceptions of patient-led surveillance during the 6 months of participation in the MEL-SELF pilot randomized controlled trial. Patient-led surveillance comprised regular skin self-examination, use of a mobile dermatoscope to image lesions of concern, and a smartphone app to track and send images to a teledermatologist for review, in addition to usual care.
MethodsSemistructured interviews were conducted with patients previously treated for melanoma localized to the skin in New South Wales, Australia, who were randomized to the patient-led surveillance (intervention group) in the trial. Thematic analysis was used to analyze the data with reference to the technology acceptance model.
ResultsWe interviewed 20 patients (n=8, 40% women and n=12, 60% men; median age 62 years). Patients who were more adherent experienced benefits such as increased awareness of their skin and improved skin self-examination practice, early detection of melanomas, and opportunities to be proactive in managing their clinical follow-up. Most participants experienced difficulty in obtaining clear images and technical problems with the app. These barriers were overcome or persevered by participants with previous experience with digital technology and with effective help from a skin check partner (such as a spouse, sibling, or friend). Having too many or too few moles decreased perceived usefulness.
ConclusionsPatients with melanoma are receptive to and experience benefits from patient-led surveillance using teledermoscopy. Increased provision of training and technical support to patients and their skin check partners may help to realize the full potential benefits of this new model of melanoma surveillance. |
| first_indexed | 2024-03-08T06:50:46Z |
| format | Article |
| id | doaj.art-1afa339e0bee4c9e991a222e16242a8f |
| institution | Directory Open Access Journal |
| issn | 2562-0959 |
| language | English |
| last_indexed | 2024-03-08T06:50:46Z |
| publishDate | 2022-07-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Dermatology |
| spelling | doaj.art-1afa339e0bee4c9e991a222e16242a8f2024-02-03T06:56:12ZengJMIR PublicationsJMIR Dermatology2562-09592022-07-0153e3591610.2196/35916Experiences of Patient-Led Surveillance, Including Patient-Performed Teledermoscopy, in the MEL-SELF Pilot Randomized Controlled Trial: Qualitative Interview StudyDorothy Drabarekhttps://orcid.org/0000-0003-2893-5863Emily Habgoodhttps://orcid.org/0000-0002-5438-2986Monika Jandahttps://orcid.org/0000-0002-1728-8085Jolyn Herschhttps://orcid.org/0000-0001-5225-6639Deonna Ackermannhttps://orcid.org/0000-0002-4089-7823Don Lowhttps://orcid.org/0000-0001-8962-946XCynthia Lowhttps://orcid.org/0000-0003-4297-1967Rachael L Mortonhttps://orcid.org/0000-0001-7834-0572Mbathio Dienghttps://orcid.org/0000-0001-6714-9633Anne E Custhttps://orcid.org/0000-0002-5331-6370Adelaide Morganhttps://orcid.org/0000-0002-2900-2611Elloise Smithhttps://orcid.org/0000-0002-7163-9755Katy L J Bellhttps://orcid.org/0000-0002-0137-3218 BackgroundCurrent clinician-led melanoma surveillance models require frequent routinely scheduled clinic visits, with associated travel, cost, and time burden for patients. Patient-led surveillance is a new model of follow-up care that could reduce health care use such as clinic visits and medical procedures and their associated costs, increase access to care, and promote early diagnosis of a subsequent new melanoma after treatment of a primary melanoma. Understanding patient experiences may allow improvements in implementation. ObjectiveThis study aims to explore patients’ experiences and perceptions of patient-led surveillance during the 6 months of participation in the MEL-SELF pilot randomized controlled trial. Patient-led surveillance comprised regular skin self-examination, use of a mobile dermatoscope to image lesions of concern, and a smartphone app to track and send images to a teledermatologist for review, in addition to usual care. MethodsSemistructured interviews were conducted with patients previously treated for melanoma localized to the skin in New South Wales, Australia, who were randomized to the patient-led surveillance (intervention group) in the trial. Thematic analysis was used to analyze the data with reference to the technology acceptance model. ResultsWe interviewed 20 patients (n=8, 40% women and n=12, 60% men; median age 62 years). Patients who were more adherent experienced benefits such as increased awareness of their skin and improved skin self-examination practice, early detection of melanomas, and opportunities to be proactive in managing their clinical follow-up. Most participants experienced difficulty in obtaining clear images and technical problems with the app. These barriers were overcome or persevered by participants with previous experience with digital technology and with effective help from a skin check partner (such as a spouse, sibling, or friend). Having too many or too few moles decreased perceived usefulness. ConclusionsPatients with melanoma are receptive to and experience benefits from patient-led surveillance using teledermoscopy. Increased provision of training and technical support to patients and their skin check partners may help to realize the full potential benefits of this new model of melanoma surveillance.https://derma.jmir.org/2022/3/e35916 |
| spellingShingle | Dorothy Drabarek Emily Habgood Monika Janda Jolyn Hersch Deonna Ackermann Don Low Cynthia Low Rachael L Morton Mbathio Dieng Anne E Cust Adelaide Morgan Elloise Smith Katy L J Bell Experiences of Patient-Led Surveillance, Including Patient-Performed Teledermoscopy, in the MEL-SELF Pilot Randomized Controlled Trial: Qualitative Interview Study JMIR Dermatology |
| title | Experiences of Patient-Led Surveillance, Including Patient-Performed Teledermoscopy, in the MEL-SELF Pilot Randomized Controlled Trial: Qualitative Interview Study |
| title_full | Experiences of Patient-Led Surveillance, Including Patient-Performed Teledermoscopy, in the MEL-SELF Pilot Randomized Controlled Trial: Qualitative Interview Study |
| title_fullStr | Experiences of Patient-Led Surveillance, Including Patient-Performed Teledermoscopy, in the MEL-SELF Pilot Randomized Controlled Trial: Qualitative Interview Study |
| title_full_unstemmed | Experiences of Patient-Led Surveillance, Including Patient-Performed Teledermoscopy, in the MEL-SELF Pilot Randomized Controlled Trial: Qualitative Interview Study |
| title_short | Experiences of Patient-Led Surveillance, Including Patient-Performed Teledermoscopy, in the MEL-SELF Pilot Randomized Controlled Trial: Qualitative Interview Study |
| title_sort | experiences of patient led surveillance including patient performed teledermoscopy in the mel self pilot randomized controlled trial qualitative interview study |
| url | https://derma.jmir.org/2022/3/e35916 |
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