RALEIGH, N.C. – Interactive computer-assisted patient education combined with a hands-on, dermatologist-led tutorial and monthly reminders proved successful in increasing the performance of skin self-examinations in a randomized controlled trial.
The intervention also resulted in significantly increased patient confidence in the ability to detect melanoma, Savina Aneja reported at the annual meeting of the Society for Investigative Dermatology.
The fact that the intervention was triple-pronged was probably the key to its success, added Ms. Aneja, a medical student at Case Western Reserve University in Cleveland.
"We know that patients exhibit different learning styles. ... Because we used a multimodal approach we appealed to a large number of different learning styles," she said.
The study included 210 adult patients in a university dermatology clinic. Their mean age was 53 years. Those randomized to the intervention arm completed an interactive computer-based program called Skinsafe on the day of enrollment. Developed in the United Kingdom, Skinsafe is designed to increase patient awareness of melanoma risk factors and symptoms, the importance of sun-protective behaviors, and skin self-examination. Patients spent 15-40 minutes to complete the Skinsafe program in a dermatologist’s office.
The intervention group also took part in a hands-on tutorial on skin self-examination, and they signed up to receive monthly reminders to perform them. Half of the subjects opted to be reminded via e-mail, 18% via the mail, 17% by phone call, and 15% by text message.
Patients in the both groups received a brochure on melanoma detection.
The primary study end point was self-reported change in skin self-examination rates over the course of 3 months of follow-up. At baseline, 43% of subjects performed skin self-exams at home. Three months later, 61% of controls and 79% of patients in the intervention group reported regular self-exams, Ms. Aneja said.
The subgroup that opted to receive monthly text-message reminders saw the greatest improvement. "We hypothesize that this is due to a greater degree of personalization. They could select the date and time of their monthly reminders," she said.
The text messages also were more likely to reach their intended recipient than either phone calls or letters, she noted.
A key secondary end point was the number of subjects at the study’s end who felt "very or somewhat confident" in their ability to detect melanoma. This figure rose by an absolute 10% over baseline in controls, compared with an absolute 40% increase, to 76%, in the intervention group.
Ms. Aneja reported having no financial conflicts.