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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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cam.issuedOnline2021-11-13
dc.contributor.authorReilly, Felicity
dc.contributor.authorContstable, Lynda
dc.contributor.authorBrant, William
dc.contributor.authorRahman, Kaz
dc.contributor.authorDurrani, Amer
dc.contributor.authorBurrows, Nigel
dc.contributor.authorProby, Charlotte
dc.contributor.authorAllan, Julia
dc.contributor.authorJohnston, Marie
dc.contributor.authorJohnston, Derek
dc.contributor.authorWalter, Fiona
dc.contributor.authorMurchie, Peter
dc.contributor.orcidWalter, Fiona [0000-0002-7191-6476]
dc.date.accessioned2021-11-22T14:36:06Z
dc.date.available2021-11-22T14:36:06Z
dc.date.issued2021-11-13
dc.date.submitted2021-04-23
dc.date.updated2021-11-22T14:36:06Z
dc.description.abstractBACKGROUND: 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.
dc.identifier.doi10.17863/CAM.78239
dc.identifier.eissn1471-2407
dc.identifier.issn1471-2407
dc.identifier.others12885-021-08959-2
dc.identifier.other8959
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/330796
dc.languageen
dc.language.isoeng
dc.publisherSpringer Science and Business Media LLC
dc.publisher.urlhttp://dx.doi.org/10.1186/s12885-021-08959-2
dc.subjectCancer
dc.subjectMelanoma
dc.subjectPrimary care
dc.subjectRandomised Controlled Trial
dc.subjectSelf-directed care
dc.subjectSurvivorship
dc.subjecte-health
dc.subjectAftercare
dc.subjectCancer Survivors
dc.subjectComputers, Handheld
dc.subjectFeasibility Studies
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMelanoma
dc.subjectMiddle Aged
dc.subjectMobile Applications
dc.subjectNeoplasm Recurrence, Local
dc.subjectNurse Practitioners
dc.subjectOncology Nursing
dc.subjectPhotography
dc.subjectPilot Projects
dc.subjectSelf Care
dc.subjectSelf-Examination
dc.subjectSkin
dc.subjectSkin Neoplasms
dc.subjectUnited Kingdom
dc.titleAchieving 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.
dc.typeArticle
dcterms.dateAccepted2021-11-01
prism.issueIdentifier1
prism.publicationNameBMC Cancer
prism.volume21
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1186/s12885-021-08959-2

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