Physician–patient communication and patient‐reported outcomes in the actinic keratosis treatment adherence initiative (<scp>AK</scp>‐<scp>TRAIN</scp>): a multicenter, prospective, real‐life study of treatment satisfaction, quality of life and adherence to topical field‐directed therapy for the treatment of actinic keratosis in Italy

Neri, Luca; Peris, Ketty; Longo, Caterina; Calvieri, Stefano; Frascione, Pasquale; Parodi, Aurora; Eibenschuz, L.; Bottoni, Ugo; Pellacani, Giovanni

doi:10.1111/jdv.15142

Cited by 24 publications

(41 citation statements)

References 31 publications

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“…[12,16] For many cases of AK, several treatment approaches are potentially suitable based on existing guidelines. This document therefore further complements existing guidelines and previous consensus papers by providing recommendations about selecting the appropriate Ingenol mebutate was one of the treatment options proposed for many of the profiles and this was driven by its association with good cosmetic outcomes [17,18] ; the predictable nature of the treatment and related short-term local skin reactions [19][20][21][22] ; and the fact that the administration regimen of ingenol mebutate allows for flexible use, as patients are able to decide how and when it is used according to their needs and individual condition. In a randomized, evaluator-blinded trial of ingenol mebutate 0.015% gel and diclofenac sodium 3% gel, patients experienced a shorter duration of skin reactions, with a peak after one week, with ingenol mebutate compared with diclofenac sodium, who experienced reactions throughout the 90-day treatment.…”

Section: Practical Recommendations For Application Of Topical Treatmentsmentioning

confidence: 89%

Patient-centered management of actinic keratosis. Results of a multi-center clinical consensus analyzing non-melanoma skin cancer patient profiles and field-treatment strategies

Philipp‐Dormston¹,

Battistella

Boussemart

et al. 2019

Journal of Dermatological Treatment

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Patient-centered management of actinic keratosis. Results of a multi-center clinical consensus analyzing non-melanoma skin cancer patient profiles and field-treatment strategies Abstract Introduction: Actinic keratosis (AK) is a chronic skin condition that can be a precursor to cutaneous squamous cell carcinoma. AK can recur and patients are likely to undergo multiple treatments. It is important that AK lesions are managed appropriately, and that patients are involved in treatment decisions. Materials and methods: The Supporting Professional Expertise in AK (SPEAK) program aims to facilitate this patient-centered care by identifying patient needs and aiding healthcare practitioners (HCPs) in selecting optimal treatment and communication strategies for different types of patients. Twenty-two dermatooncologists with established expertise in the treatment of AK collaborated to describe commonly encountered psychosocial patient profiles, and to develop respective communication and treatment strategies. Results and conclusion: Six patient profiles were defined based on different psychosocial characteristics and were used to develop appropriate management approaches. We provide a systematic way of identifying these patient profiles in clinical practice and we outline communication strategies tailored to the primary needs of each type of patient. In addition, we provide recommendations for potential fieldtreatments that may be best suited for each profile. The recommendations provided here may help improve the communication and relationship between patients and HCPs, resulting in higher treatment adherence and improved patient outcomes.

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Section: Practical Recommendations For Application Of Topical Treatmentsmentioning

confidence: 89%

Patient-centered management of actinic keratosis. Results of a multi-center clinical consensus analyzing non-melanoma skin cancer patient profiles and field-treatment strategies

Philipp‐Dormston¹,

Battistella

Boussemart

et al. 2019

Journal of Dermatological Treatment

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“…Only four studies were clinical trials. 10,[23][24][25] Investigations were designed prevalently as national studies (10/14) 6,8,10,12,[15][16][17]22,23,26 and carried out in North America, 10,15 Europe, 8,16,17,22,26 South America, 6,23 and Australia. 12 Brazil was the only represented South American country, 6,23 and no data were present to represent Asian and African countries.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…6,22,24 5% to 57.9% of patients had a previous history of skin cancer, while 19.3% to 90.3% had been previously treated for AK. 6,8,10,12,13,[15][16][17]19,[22][23][24][25][26] The majority of the patients belonged to Fitzaptrick's skin phototypes I and II. In relation to satisfaction regarding the adverse effects, the group treated with DFS showed higher satisfaction compared to the group treated with 5-FU, with 93.3% and 38.4% of highly satisfied patients, respectively.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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Patient‐reported outcomes of topical therapies in actinic keratosis: A systematic review

Grada¹,

Feldman

Bragazzi

et al. 2021

Dermatologic Therapy

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Patients' perspectives on actinic keratosis treatments may have an impact on treatment adherence and, therefore, therapeutic outcomes. We performed a systematic review to assess patients' perspectives of topical, field-directed treatments for actinic keratoses. A literature search was conducted, and 14 studies were identified encompassing 4433 patients. Only four studies were focused on face and/or scalp, which are the locations that typically impact patients' quality of life. Four studies were clinical trials. One study utilized a validated patient-reported outcomes (PRO) instrument specifically developed for actinic keratosis. In general, treatment adherence and patient satisfaction were better with shorter-duration treatment regimens such as ingenol mebutate gel. Imiquimod improved quality of life in one study but not in another. No data was available on topical piroxicam. The findings underscore the need for effective and well-tolerated, shortduration topical treatment for actinic keratosis.

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“…Discussing the treatment-associated local site reactions (LSRs) before therapy may lead to delay in treatment initiation. During treatment, such reactions cause distress [6] and impact health-related quality of life [7]. A study by Strohal et al [8] showed that 19.4% of patients treated with imiquimod 5% cream, scheduled unplanned visits due to their concern of LSRs.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, Discontinuation Rate, and Risk Factors for Severe Local Site Reactions with Topical Field Treatment Options for Actinic Keratosis of the Face and Scalp

et al. 2019

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Actinic keratoses (AKs) are common lesions on chronically sun damaged skin, which are morphologically characterized by lower third to full thickness atypia of epidermal keratinocytes. These lesions carry a risk of progression towards invasive squamous cell carcinoma (SCC); therefore, treatment of visible lesions and the field in case of field cancerization is recommended. Treatment of AK includes the destruction of atypical keratinocytes that clinically presents with various degrees of erythema, scaling, crusting, erosion, and other visible and subjective symptoms. Such inflammatory reactions may have an impact on the patient’s social life and have shown to decrease compliance and adherence to therapy. Additionally, as various topical treatments have been proven to be effective in treating AK, tolerability of local site reactions (LSRs) might drive the decision for appropriate treatment in an individual scenario. Therefore, we aimed to review prevalence of severe LSRs among various topical treatments for AK. In addition, we summarized discontinuation rates due to LSRs and possible therapy-unrelated risk factors for the development of LSRs with increased severity.

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Cited by 24 publications

References 31 publications

Patient-centered management of actinic keratosis. Results of a multi-center clinical consensus analyzing non-melanoma skin cancer patient profiles and field-treatment strategies

Patient-centered management of actinic keratosis. Results of a multi-center clinical consensus analyzing non-melanoma skin cancer patient profiles and field-treatment strategies

Patient‐reported outcomes of topical therapies in actinic keratosis: A systematic review

Prevalence, Discontinuation Rate, and Risk Factors for Severe Local Site Reactions with Topical Field Treatment Options for Actinic Keratosis of the Face and Scalp

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