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一种提高患者对光化性角化病局部治疗依从性和持续性的共识方法。

A consensus approach to improving patient adherence and persistence with topical treatment for actinic keratosis.

作者信息

Stockfleth Eggert, Peris Ketty, Guillen Carlos, Cerio Rino, Basset-Seguin Nicole, Foley Peter, Sanches José, Culshaw Alex, Erntoft Sandra, Lebwohl Mark

机构信息

Klinik für Dermatologie, Venerologie und Allergologie St. Josef-Hospital, Ruhr-Universität Bochum, Bochum, Germany.

出版信息

Int J Dermatol. 2015;54(5):509-15. doi: 10.1111/ijd.12840. Epub 2015 Apr 10.

Abstract

BACKGROUND

Topical therapy is important in the treatment of actinic keratosis, but guidance for improving adherence/persistence during topical therapy is still lacking.

OBJECTIVES

To utilize expert consensus to generate a list of recommendations to improve real-world efficacy when prescribing topical therapy for actinic keratosis.

METHODS

An expert panel of eight dermatologists was convened to generate recommendations based on facilitated discussion and consensus generation using a modified Delphi session. The recommendations were ratified with the expert panel.

RESULTS

Facilitated discussion generated 31 issues within five themes, which were prioritized using expert voting. Consensus was achieved on the importance of short and simple treatment regimens for maximizing patient compliance, physician awareness of the progression of actinic keratosis to squamous cell carcinoma, provision of appropriate patient information, and the use of effective communication strategies to educate physicians about actinic keratosis. Based on these key findings, eight recommendations were generated.

CONCLUSIONS

The recommendations will assist physicians when prescribing topical actinic keratosis therapy. Further research should focus on the types of patient outcomes that are influenced by the characteristics of topical field therapy.

摘要

背景

局部治疗在光化性角化病的治疗中很重要,但在局部治疗期间改善依从性/持续性的指导意见仍然缺乏。

目的

利用专家共识生成一份建议清单,以提高在为光化性角化病开局部治疗处方时的实际疗效。

方法

召集了一个由八位皮肤科医生组成的专家小组,通过使用改良的德尔菲会议进行促进性讨论和达成共识来生成建议。这些建议经专家小组批准。

结果

促进性讨论在五个主题内产生了31个问题,通过专家投票对这些问题进行了优先级排序。就以下方面达成了共识:采用简短且简单的治疗方案以最大限度提高患者依从性的重要性、医生对光化性角化病进展为鳞状细胞癌的认识、提供适当的患者信息以及使用有效的沟通策略来教育医生有关光化性角化病的知识。基于这些关键发现,生成了八项建议。

结论

这些建议将有助于医生为光化性角化病开局部治疗处方。进一步的研究应侧重于受局部区域治疗特征影响的患者结局类型。

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