Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Acceptability and feasibility of personalised, systematic melanoma risk assessment from the perspective of patients and clinic staff: a qualitative study (#234)

Amelia K Smit 1 2 3 , Andrea L Smith 1 , Bela I Laginha 4 , Nehal Singh 5 , Frances Rapport 5 , Bruna Gallo 2 , Jeffrey Braithwaite 5 , Linda Martin 2 6 , Anne E Cust 1 2 7
  1. Daffodil Centre, The University of Sydney, The University Of Sydney, NSW, Australia
  2. Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
  3. The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Sydney, NSW, Australia
  4. Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, NSW, Australia
  5. Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
  6. Faculty of Medicine and Health, University of New South Wales , Sydney, NSW, Australia
  7. The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Sydney, NSW, Australia

Background: Recent Australian clinical practice guidelines recommend that the assessment of melanoma risk should be integrated into skin cancer care provision. There is a need for research on how personal risk information can be incorporated into skin cancer prevention and surveillance frequency advice.

Aim: To explore the acceptability and feasibility of personalised melanoma risk assessment and tailored patient education and skin surveillance within routine clinical care in the Melanoma Institute Australia dermatology clinic. 

Methods: This qualitative (semi-structured interviews and observations) study was informed by the Theoretical Framework of Acceptability (TFA). Personalised, systematic melanoma risk assessment was implemented at a skin-cancer focused dermatology clinic in February 2021. Observations were performed pre- and post-implementation in the waiting room and during clinical consultations. Semi-structured interviews with patients and clinic staff explored their experiences of delivering or receiving personalised melanoma risk scores, tailored surveillance schedules and skin cancer education. Observational and interview data were analysed thematically using the TFA as a classifying framework.

Results: Pre- and post-implementation observations were performed at the clinic from September 2020-March 2021 (total of 37 hours); 29 patients and 12 clinic staff were interviewed. We found that the delivery of personalised melanoma risk scores did not impact on patient flow through the clinic. Dermatologists reported that the personalised risk information enhanced their confidence in recommending surveillance schedules and enabled improved identification of high- and low-risk groups. Most patients reported that the risk assessment and tailored information was a beneficial addition to their care. Among patients whose risk deviated from their expectations some reported feeling worried, particularly those at low risk who were recommended to decrease surveillance frequency.

Conclusions: It is feasible and acceptable to patients and clinic staff to calculate and deliver personalised melanoma risk information as part of routine clinical care within dermatology clinics.