S F K Lubeek1, R J Borgonjen2, L J van Vugt2, M G Olde Rikkert3, P C M van de Kerkhof2, M J P Gerritsen2. 1. Department of Dermatology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands. Satish.Lubeek@radboudumc.nl. 2. Department of Dermatology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands. 3. Department of Geriatrics, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands.
Abstract
BACKGROUND: Balancing treatment decisions in frail older adults with nonmelanoma skin cancer (NMSC) can be challenging. Clinical practice guidelines (CPGs) could provide assistance. OBJECTIVES: To collect and prioritize items related to frail older adults with NMSC for integration into CPGs and to assess the current extent of this integration. METHODS: Items were collected and prioritized by a multidisciplinary working group (29 members) using a modified Delphi procedure and a five-point Likert scale. To assess current integration of these items in CPGs, a systematic review was subsequently performed by two independent reviewers using five medical databases (PubMed, Embase, Cochrane Library, SUMsearch and Trip Database), websites of guideline developers/databases, and (inter)national dermatological societies. RESULTS: Prioritization of a final 13-item list showed that 'limited life expectancy' (4·5 ± 0·9) and 'treatment goals other than cure' (4·4 ± 0·7) were most desired to be integrated into CPGs; both were included in six (46%) of the CPGs found (n = 13). Attention to 'tumour characteristics' and 'comorbidities' were included in CPGs most often (100% and 77%, respectively). CONCLUSIONS: More attention to items related to frail older adults in NMSC CPGs is broadly desired, but CPG integration of these items is currently limited. More integration might stimulate more holistic, personalized and patient-centred care in frail older adults.
BACKGROUND: Balancing treatment decisions in frail older adults with nonmelanoma skin cancer (NMSC) can be challenging. Clinical practice guidelines (CPGs) could provide assistance. OBJECTIVES: To collect and prioritize items related to frail older adults with NMSC for integration into CPGs and to assess the current extent of this integration. METHODS: Items were collected and prioritized by a multidisciplinary working group (29 members) using a modified Delphi procedure and a five-point Likert scale. To assess current integration of these items in CPGs, a systematic review was subsequently performed by two independent reviewers using five medical databases (PubMed, Embase, Cochrane Library, SUMsearch and Trip Database), websites of guideline developers/databases, and (inter)national dermatological societies. RESULTS: Prioritization of a final 13-item list showed that 'limited life expectancy' (4·5 ± 0·9) and 'treatment goals other than cure' (4·4 ± 0·7) were most desired to be integrated into CPGs; both were included in six (46%) of the CPGs found (n = 13). Attention to 'tumour characteristics' and 'comorbidities' were included in CPGs most often (100% and 77%, respectively). CONCLUSIONS: More attention to items related to frail older adults in NMSC CPGs is broadly desired, but CPG integration of these items is currently limited. More integration might stimulate more holistic, personalized and patient-centred care in frail older adults.
Authors: Marjolijn S Haisma; Linda Bras; Mehran Alizadeh Aghdam; Jorrit B Terra; Boudewijn E C Plaat; Emöke Rácz; Gyorgy B Halmos Journal: Acta Derm Venereol Date: 2020-06-18 Impact factor: 3.875
Authors: M E C van Winden; S Garcovich; K Peris; G Colloca; E M G J de Jong; M E Hamaker; P C M van de Kerkhof; S F K Lubeek Journal: J Eur Acad Dermatol Venereol Date: 2020-07-01 Impact factor: 9.228