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

Br J Dermatol. 2019 Jan;180(1):122-129. doi: 10.1111/bjd.16900. Epub 2018 Sep 23.

Abstract

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.

MeSH terms

  • Aftercare / methods
  • Aftercare / organization & administration
  • Aged
  • Aged, 80 and over
  • Carcinoma, Basal Cell / diagnosis
  • Carcinoma, Basal Cell / therapy*
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / therapy*
  • Decision Making
  • Dermatology / methods
  • Dermatology / organization & administration
  • Dermatology / standards
  • Evidence-Based Medicine / methods
  • Evidence-Based Medicine / organization & administration
  • Evidence-Based Medicine / standards
  • Female
  • Focus Groups
  • Health Services Needs and Demand*
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Patient Participation
  • Patient Preference*
  • Patient-Centered Care / methods
  • Patient-Centered Care / organization & administration
  • Patient-Centered Care / standards
  • Physician-Patient Relations
  • Practice Guidelines as Topic
  • Qualitative Research
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / therapy*