Steeb Theresa, Wessely Anja, von Bubnoff Dagmar, Dirschka Thomas, Drexler Konstantin, Falkenberg Conrad, Hassel Jessica C, Hayani Kinan, Hüning Svea, Kähler Katharina C, Karrer Sigrid, Krammer Christian, Leiter Ulrike, Lill Diana, Marsela Enklajd, Meiwes Andreas, Nashan Dorothée, Nasifoglu Suzan, Schmitz Lutz, Sirokay Judith, Thiem Alexander, Utikal Jochen, Zink Alexander, Berking Carola, Heppt Markus V
Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
Department of Dermatology and Allergy, University Hospital, LMU Munich, 80337 Munich, Germany.
J Clin Med. 2020 May 12;9(5):1438. doi: 10.3390/jcm9051438.
Patient-centered motives and expectations of the treatment of actinic keratoses (AK) have received little attention until now. Hence, we aimed to profile and cluster treatment motivations and expectations among patients with AK in a nationwide multicenter, cross-sectional study including patients from 14 German skin cancer centers. Patients were asked to complete a self-administered questionnaire. Treatment motives and expectations towards AK management were measured on a visual analogue scale from 1-10. Specific patient profiles were investigated with subgroup and correlation analysis. Overall, 403 patients were included. The highest motivation values were obtained for the items "avoid transition to invasive squamous cell carcinoma" (mean ± standard deviation; 8.98 ± 1.46), "AK are considered precancerous lesions" (8.72 ± 1.34) and "treating physician recommends treatment" (8.10 ± 2.37; < 0.0001). The highest expectation values were observed for the items "effective lesion clearance" (8.36 ± 1.99), "safety" (8.20 ± 2.03) and "treatment-related costs are covered by health insurance" (8.00 ± 2.41; < 0.0001). Patients aged ≥77 years and those with ≥7 lesions were identified at high risk of not undergoing any treatment due to intrinsic and extrinsic motivation deficits. Heat mapping of correlation analysis revealed four clusters with distinct motivation and expectation profiles. This study provides a patient-based heuristic tool for a personalized treatment decision in patients with AK.
直到现在，以患者为中心的光化性角化病（AK）治疗动机和期望很少受到关注。因此，在一项全国性多中心横断面研究中，我们旨在剖析并聚类AK患者的治疗动机和期望，该研究纳入了来自14个德国皮肤癌中心的患者。患者被要求完成一份自填式问卷。对AK治疗的动机和期望采用1 - 10的视觉模拟量表进行测量。通过亚组分析和相关性分析对特定患者特征进行了研究。总体而言，共纳入403例患者。“避免转变为浸润性鳞状细胞癌”（均值±标准差；8.98±1.46）、“AK被视为癌前病变”（8.72±1.34）和“治疗医生建议治疗”（8.10±2.37；<0.0001）这些项目获得了最高的动机值。“有效清除病变”（8.36±1.99）、“安全性”（8.20±2.03）和“治疗相关费用由医疗保险支付”（8.00±2.41；<0.0001）这些项目观察到了最高的期望值。年龄≥77岁的患者以及有≥7处病变的患者被确定因内在和外在动机缺陷而有不接受任何治疗的高风险。相关性分析的热图显示了四个具有不同动机和期望特征的聚类。本研究为AK患者的个性化治疗决策提供了一种基于患者的启发式工具。
