Needs and preferences of patients regarding basal cell carcinoma and cutaneous squamous cell carcinoma care: a qualitative focus group study

• Published in: British journal of dermatology (1951) Vol. 180; no. 1; pp. 122 - 129
• Main Authors: Egmond, S., Wakkee, M., Droger, M., Bastiaens, M.T., Rengen, A., Roos, K.P., Nijsten, T., Lugtenberg, M.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.01.2019
• Subjects: Basal cell carcinoma; Communication; Decision making; Focus groups; Health care delivery; Patient education; Patient satisfaction; Patients; Preferences; Qualitative research; Skin cancer; Squamous cell carcinoma
• ISSN: 0007-0963; 1365-2133
• DOI: 10.1111/bjd.16900

Summary Background Despite the high and rising incidence rate of keratinocyte cancer (KC) and the importance of incorporating patient values into evidence‐based care, few studies have focused on the perspectives of patients with KC. Objectives To identify the needs and preferences of patients with basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) regarding care. Methods A qualitative study was conducted consisting of three focus groups with patients with BCC and three focus groups with patients with SCC. In total 42 patients participated. In each focus group, the patients’ needs and preferences regarding treatment and follow‐up were discussed, using a predefined topic list. All sessions were transcribed verbatim and analysed by two researchers. Results The following needs and preferences were identified: (i) the need to receive all relevant, tailored information; (ii) a physician who takes you seriously and communicates well; (iii) a short waiting period and the best treatment with direct results; (iv) to be seen by the same physician; a preference for a dermatologist during (v) treatment and (vi) follow‐up; (vii) a general need for structured follow‐up care and (viii) a full‐body skin examination during follow‐up. Patients with BCC additionally expressed the need for openness and transparency and wanting to participate in shared decision making. Conclusions It is advocated to organize skin cancer care that is better tailored to the needs of patients with KC, providing patient‐centred care. This should include investing in the patient–physician relationship, and personalizing the type and form of information and the follow‐up schedules. Adding the patient's perspective to current guidelines could facilitate this process. What's already known about this topic? The incidence of skin cancer is high and increasing, which poses a considerable burden on healthcare systems. Patient values are a core component of evidence‐based care, yet studies focusing on patients’ needs and preferences regarding care for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are scarce. What does this study add? This qualitative study provides an in‐depth understanding of the preferences of patients with keratinocyte cancer and needs regarding care. Patients with BCC and SCC emphasized the importance of receiving all relevant information tailored to their specific situation. Patients with BCC additionally expressed the need to participate in shared decision making, whereas patients with SCC stated that they do not want to be involved. Whereas both patient groups prefer periodic follow‐up visits, some patients with BCC indicated not needing this if they have quick access to a dermatologist whenever they detect new lesions. What are the clinical implications of this work? In order to tailor care to the needs and preferences of patients with BCC and SCC, it is advocated to provide patient‐centred care. This should involve investing in the patient–physician relationship and personalizing the type and form of information, the methods of explanation and the follow‐up schedules. The patients’ perspectives found in this study may be incorporated into BCC and SCC guidelines in order to improve quality of care. Linked Comment: Magin. Br J Dermatol 2019; 180:22–23. Plain language summary available online Respond to this article