Achieving integrated self-directed Cancer aftercare (ASICA) for melanoma: how a digital intervention to support total skin self-examination was used by people treated for cutaneous melanoma

Abstract Background Melanoma incidence has quadrupled since 1970 and melanoma is now the second most common cancer in individuals under 50. Targeted immunotherapies for melanoma now potentially enable long-term remission even in advanced melanoma, but these melanoma survivors require ongoing surveil...

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Autores principales:	Felicity Reilly, Lynda Contstable, William Brant, Kaz Rahman, Amer Durrani, Nigel Burrows, Charlotte Proby, Julia Allan, Marie Johnston, Derek Johnston, Fiona Walter, Peter Murchie
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Primary care Melanoma Cancer Randomised Controlled Trial Survivorship Self-directed care Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/3d5722047d3e4a12a270602271c0b8ce
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spelling	oai:doaj.org-article:3d5722047d3e4a12a270602271c0b8ce2021-11-14T12:30:14ZAchieving integrated self-directed Cancer aftercare (ASICA) for melanoma: how a digital intervention to support total skin self-examination was used by people treated for cutaneous melanoma10.1186/s12885-021-08959-21471-2407https://doaj.org/article/3d5722047d3e4a12a270602271c0b8ce2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12885-021-08959-2https://doaj.org/toc/1471-2407Abstract Background Melanoma incidence has quadrupled since 1970 and melanoma is now the second most common cancer in individuals under 50. Targeted immunotherapies for melanoma now potentially enable long-term remission even in advanced melanoma, but these melanoma survivors require ongoing surveillance, with implications for NHS resources and significant social and psychological consequences for patients. Total skin self-examination (TSSE) can detect recurrence earlier and improve clinical outcomes but is underperformed in the UK. To support survivors, the Achieving Self-directed Integrated Cancer Aftercare (ASICA) intervention was developed to prompt and improve TSSE performance, with subsequent reporting of concerns and submission of skin photos to a Dermatology Nurse Practitioner (DNP). ASICA was delivered as a randomized pilot trial. Methods This paper reports on process evaluation. Data on participants’ demographics and the concerns they reported during the trial were tabulated and displayed using Microsoft Excel and SPSS. We explored which participants used ASICA, and how frequently, to report any skin concerns. We also determined how the interactions had worked in terms of quality of skin photographs submitted, clinical assessments made by the DNP, and the assessments and decisions made for each concern. Finally, we explored significant events occurring during the trial. Data on participants’ demographics and the concerns they reported during the trial were tabulated and displayed using SPSS. A semi-structured interview was undertaken with the DNP to gain perspective on the range of concerns presented and how they were resolved. Results Of 121 recruited melanoma patients receiving ASICA for 12 months, 69 participants submitted a total of 123 reports detailing 189 separate skin-related concerns and including 188 skin photographs. Where participants fully complied with follow-up by the DNP, concerns were usually resolved remotely, but 19 (10.1%) were seen at a secondary care clinic and 14 (7.4%) referred to their GP. 49 (25.9%) of concerns were not completely resolved due to partial non-compliance with DNP follow-up. Conclusion Melanoma patients randomized to the ASICA intervention were able to report skin-related concerns that could be resolved remotely through interaction with a DNP. Feasibility issues highlighted by ASICA will support further development and optimization of this digital tool. Trial registration Clinical Trials.gov , NCT03328247 . Registered on 1 November 2017Felicity ReillyLynda ContstableWilliam BrantKaz RahmanAmer DurraniNigel BurrowsCharlotte ProbyJulia AllanMarie JohnstonDerek JohnstonFiona WalterPeter MurchieBMCarticlePrimary careMelanomaCancerRandomised Controlled TrialSurvivorshipSelf-directed careNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBMC Cancer, Vol 21, Iss 1, Pp 1-15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Primary care Melanoma Cancer Randomised Controlled Trial Survivorship Self-directed care Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Primary care Melanoma Cancer Randomised Controlled Trial Survivorship Self-directed care Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Felicity Reilly Lynda Contstable William Brant Kaz Rahman Amer Durrani Nigel Burrows Charlotte Proby Julia Allan Marie Johnston Derek Johnston Fiona Walter Peter Murchie Achieving integrated self-directed Cancer aftercare (ASICA) for melanoma: how a digital intervention to support total skin self-examination was used by people treated for cutaneous melanoma
description	Abstract Background Melanoma incidence has quadrupled since 1970 and melanoma is now the second most common cancer in individuals under 50. Targeted immunotherapies for melanoma now potentially enable long-term remission even in advanced melanoma, but these melanoma survivors require ongoing surveillance, with implications for NHS resources and significant social and psychological consequences for patients. Total skin self-examination (TSSE) can detect recurrence earlier and improve clinical outcomes but is underperformed in the UK. To support survivors, the Achieving Self-directed Integrated Cancer Aftercare (ASICA) intervention was developed to prompt and improve TSSE performance, with subsequent reporting of concerns and submission of skin photos to a Dermatology Nurse Practitioner (DNP). ASICA was delivered as a randomized pilot trial. Methods This paper reports on process evaluation. Data on participants’ demographics and the concerns they reported during the trial were tabulated and displayed using Microsoft Excel and SPSS. We explored which participants used ASICA, and how frequently, to report any skin concerns. We also determined how the interactions had worked in terms of quality of skin photographs submitted, clinical assessments made by the DNP, and the assessments and decisions made for each concern. Finally, we explored significant events occurring during the trial. Data on participants’ demographics and the concerns they reported during the trial were tabulated and displayed using SPSS. A semi-structured interview was undertaken with the DNP to gain perspective on the range of concerns presented and how they were resolved. Results Of 121 recruited melanoma patients receiving ASICA for 12 months, 69 participants submitted a total of 123 reports detailing 189 separate skin-related concerns and including 188 skin photographs. Where participants fully complied with follow-up by the DNP, concerns were usually resolved remotely, but 19 (10.1%) were seen at a secondary care clinic and 14 (7.4%) referred to their GP. 49 (25.9%) of concerns were not completely resolved due to partial non-compliance with DNP follow-up. Conclusion Melanoma patients randomized to the ASICA intervention were able to report skin-related concerns that could be resolved remotely through interaction with a DNP. Feasibility issues highlighted by ASICA will support further development and optimization of this digital tool. Trial registration Clinical Trials.gov , NCT03328247 . Registered on 1 November 2017
format	article
author	Felicity Reilly Lynda Contstable William Brant Kaz Rahman Amer Durrani Nigel Burrows Charlotte Proby Julia Allan Marie Johnston Derek Johnston Fiona Walter Peter Murchie
author_facet	Felicity Reilly Lynda Contstable William Brant Kaz Rahman Amer Durrani Nigel Burrows Charlotte Proby Julia Allan Marie Johnston Derek Johnston Fiona Walter Peter Murchie
author_sort	Felicity Reilly
title	Achieving integrated self-directed Cancer aftercare (ASICA) for melanoma: how a digital intervention to support total skin self-examination was used by people treated for cutaneous melanoma
title_short	Achieving integrated self-directed Cancer aftercare (ASICA) for melanoma: how a digital intervention to support total skin self-examination was used by people treated for cutaneous melanoma
title_full	Achieving integrated self-directed Cancer aftercare (ASICA) for melanoma: how a digital intervention to support total skin self-examination was used by people treated for cutaneous melanoma
title_fullStr	Achieving integrated self-directed Cancer aftercare (ASICA) for melanoma: how a digital intervention to support total skin self-examination was used by people treated for cutaneous melanoma
title_full_unstemmed	Achieving integrated self-directed Cancer aftercare (ASICA) for melanoma: how a digital intervention to support total skin self-examination was used by people treated for cutaneous melanoma
title_sort	achieving integrated self-directed cancer aftercare (asica) for melanoma: how a digital intervention to support total skin self-examination was used by people treated for cutaneous melanoma
publisher	BMC
publishDate	2021
url	https://doaj.org/article/3d5722047d3e4a12a270602271c0b8ce
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Achieving integrated self-directed Cancer aftercare (ASICA) for melanoma: how a digital intervention to support total skin self-examination was used by people treated for cutaneous melanoma

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