BACKGROUND: Patients treated for melanoma are advised to have lifelong full body skin examinations. Extended intervals between examinations have been proposed, but although this may be clinically effective, psychosocial aspects of follow-up are not well understood. This systematic review summarised patient and clinician preferences, experiences and adherence with recommended follow-up of stage I/II melanoma. METHODS: Medline, PsycINFO, CINAHL, Embase, Cochrane Library, ACP Journal Club and NHS Economic Evaluation Database were searched from database inception to week 3 April 2010, to identify original studies of psychosocial outcomes of follow-up after treatment of stage I/II primary cutaneous melanoma, as reported by patients or clinicians. The results were synthesised, and characteristics likely to maximise patients' well-being and adherence to follow-up schedules were proposed. RESULTS: We found 15 studies that met the inclusion criteria. Anxiety with melanoma follow-up was common; patients valued reassurance, information and psychosocial support, but long-term adherence to schedules was variable. Some wanted more emotional support from their clinician than was provided. Clinicians sometimes ordered additional blood and imaging tests to reassure patients. GPs were hesitant to conduct melanoma follow-up, but a trial providing technical training and protocols reported positive outcomes. Both patients and GPs wanted prompt access to melanoma specialists when suspicious lesions were found. CONCLUSION: Psychosocial aspects of follow-up impact on patient well-being and potential adherence to schedules, and may influence clinician practice. If follow-up schedules or personnel are to be revised, psychosocial impacts on patients must be explicitly addressed, as well as guidance and specialist support for clinicians.
BACKGROUND:Patients treated for melanoma are advised to have lifelong full body skin examinations. Extended intervals between examinations have been proposed, but although this may be clinically effective, psychosocial aspects of follow-up are not well understood. This systematic review summarised patient and clinician preferences, experiences and adherence with recommended follow-up of stage I/II melanoma. METHODS: Medline, PsycINFO, CINAHL, Embase, Cochrane Library, ACP Journal Club and NHS Economic Evaluation Database were searched from database inception to week 3 April 2010, to identify original studies of psychosocial outcomes of follow-up after treatment of stage I/II primary cutaneous melanoma, as reported by patients or clinicians. The results were synthesised, and characteristics likely to maximise patients' well-being and adherence to follow-up schedules were proposed. RESULTS: We found 15 studies that met the inclusion criteria. Anxiety with melanoma follow-up was common; patients valued reassurance, information and psychosocial support, but long-term adherence to schedules was variable. Some wanted more emotional support from their clinician than was provided. Clinicians sometimes ordered additional blood and imaging tests to reassure patients. GPs were hesitant to conduct melanoma follow-up, but a trial providing technical training and protocols reported positive outcomes. Both patients and GPs wanted prompt access to melanoma specialists when suspicious lesions were found. CONCLUSION: Psychosocial aspects of follow-up impact on patient well-being and potential adherence to schedules, and may influence clinician practice. If follow-up schedules or personnel are to be revised, psychosocial impacts on patients must be explicitly addressed, as well as guidance and specialist support for clinicians.
Authors: Wei-Yin Lim; Rachael L Morton; Robin M Turner; Marisa C Jenkins; Pascale Guitera; Les Irwig; Angela C Webster; Mbathio Dieng; Robyn P M Saw; Donald Low; Cynthia Low; Katy J L Bell Journal: JAMA Dermatol Date: 2018-04-01 Impact factor: 10.282
Authors: Deonna M Ackermann; Mbathio Dieng; Ellie Medcalf; Marisa C Jenkins; Cathelijne H van Kemenade; Monika Janda; Robin M Turner; Anne E Cust; Rachael L Morton; Les Irwig; Pascale Guitera; H Peter Soyer; Victoria Mar; Jolyn K Hersch; Donald Low; Cynthia Low; Robyn P M Saw; Richard A Scolyer; Dorothy Drabarek; David Espinoza; Anthony Azzi; Alister M Lilleyman; Amelia K Smit; Peter Murchie; John F Thompson; Katy J L Bell Journal: JAMA Dermatol Date: 2022-01-01 Impact factor: 11.816
Authors: Oxana Palesh; Arianna Aldridge-Gerry; Kelly Bugos; David Pickham; Jie Jane Chen; Ralph Greco; Susan M Swetter Journal: Support Care Cancer Date: 2014-05-31 Impact factor: 3.603
Authors: Sabine Fischbeck; Barbara H Imruck; Maria Blettner; Veronika Weyer; Harald Binder; Sylke R Zeissig; Katharina Emrich; Peter Friedrich-Mai; Manfred E Beutel Journal: PLoS One Date: 2015-08-21 Impact factor: 3.240
Authors: Lucie Rychetnik; Rachael L Morton; Kirsten McCaffery; John F Thompson; Scott W Menzies; Les Irwig Journal: BMC Health Serv Res Date: 2012-12-19 Impact factor: 2.655