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Open AccessArticle

Treatment Motivations and Expectations in Patients with Actinic Keratosis: A German-Wide Multicenter, Cross-Sectional Trial

1
Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
2
Department of Dermatology and Allergy, University Hospital, LMU Munich, 80337 Munich, Germany
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Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), 91054 Erlangen, Germany
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Department of Dermatology, University Hospital Schleswig-Holstein Campus Lübeck, 23562 Lübeck, Germany
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Centroderm Clinic, 42287 Wuppertal, Germany
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Department of Dermatology, University Hospital Regensburg, 93042 Regensburg, Germany
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Section of Dermatooncology, Department of Dermatology and National Center for Tumor Diseases, 69120 Heidelberg, Germany
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Department of Dermatology, Hospital of Dortmund, 44137 Dortmund, Germany
9
Department of Dermatology, University Hospital Schleswig-Holstein Campus Kiel, 24105 Kiel, Germany
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Department of Dermatology, Center for Dermatooncology, University Hospital Tübingen, 72076 Tübingen, Germany
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Department of Dermatology, Skin Cancer Center, Ruhr University Bochum, 44801 Bochum, Germany
12
Department of Dermatology and Allergy, University Hospital of Bonn, 53127 Bonn, Germany
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Clinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany
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Skin Cancer Unit, German Cancer Research Center (DKFZ) and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, 68167 Mannheim, Germany
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Department of Dermatology and Allergy, Technical University of Munich, 80802 Munich, Germany
*
Author to whom correspondence should be addressed.
Equal authorship contribution.
J. Clin. Med. 2020, 9(5), 1438; https://doi.org/10.3390/jcm9051438
Received: 1 April 2020 / Revised: 7 May 2020 / Accepted: 8 May 2020 / Published: 12 May 2020
(This article belongs to the Section Dermatology)
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; p < 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; p < 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. View Full-Text
Keywords: skin cancer; patient education; actinic keratosis; cross-sectional study; patient-centered care; patient-reported outcomes; personalized medicine skin cancer; patient education; actinic keratosis; cross-sectional study; patient-centered care; patient-reported outcomes; personalized medicine
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Figure 1

MDPI and ACS Style

Steeb, T.; Wessely, A.; von Bubnoff, D.; Dirschka, T.; Drexler, K.; Falkenberg, C.; Hassel, J.C.; Hayani, K.; Hüning, S.; Kähler, K.C.; Karrer, S.; Krammer, C.; Leiter, U.; Lill, D.; Marsela, E.; Meiwes, A.; Nashan, D.; Nasifoglu, S.; Schmitz, L.; Sirokay, J.; Thiem, A.; Utikal, J.; Zink, A.; Berking, C.; Heppt, M.V. Treatment Motivations and Expectations in Patients with Actinic Keratosis: A German-Wide Multicenter, Cross-Sectional Trial. J. Clin. Med. 2020, 9, 1438. https://doi.org/10.3390/jcm9051438

AMA Style

Steeb T, Wessely A, von Bubnoff D, Dirschka T, Drexler K, Falkenberg C, Hassel JC, Hayani K, Hüning S, Kähler KC, Karrer S, Krammer C, Leiter U, Lill D, Marsela E, Meiwes A, Nashan D, Nasifoglu S, Schmitz L, Sirokay J, Thiem A, Utikal J, Zink A, Berking C, Heppt MV. Treatment Motivations and Expectations in Patients with Actinic Keratosis: A German-Wide Multicenter, Cross-Sectional Trial. Journal of Clinical Medicine. 2020; 9(5):1438. https://doi.org/10.3390/jcm9051438

Chicago/Turabian Style

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. 2020. "Treatment Motivations and Expectations in Patients with Actinic Keratosis: A German-Wide Multicenter, Cross-Sectional Trial" J. Clin. Med. 9, no. 5: 1438. https://doi.org/10.3390/jcm9051438

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