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Cited by 11Healthcare cost, quality, practicesNonmelanoma Skin Cancer StudiesEconomic and Financial Impacts of Cancer

Factors influencing current low‐value follow‐up care after basal cell carcinoma and suggested strategies for de‐adoption: a qualitative study

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Egmond, S., Wakkee, M., Rengen, A., Bastiaens, M.T., Nijsten, T., Lugtenberg, M.·2019·British Journal of Dermatology
DOI 10.1111/bjd.17594PMC PMC6850416
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Abstract

BACKGROUND: Providing follow-up to patients with low-risk basal cell carcinoma (BCC) can be considered as low-value care. However, dermatologists still provide substantial follow-up care to this patient group, for reasons not well understood. OBJECTIVES: To identify factors influencing current BCC follow-up practices among dermatologists and suggested strategies to de-adopt this low-value care. In addition, views of patients regarding follow-up care were explored. METHODS: A qualitative study was conducted consisting of 18 semistructured interviews with dermatologists and three focus groups with a total of 17 patients with low-risk BCC who had received dermatological care. The interviews focused on current follow-up practices, influencing factors and suggested strategies to de-adopt the follow-up care. The focus groups discussed preferred follow-up schedules and providers, as well as the content of follow-up. All (group) interviews were transcribed verbatim and analysed by two researchers using ATLAS.ti software. RESULTS: Factors influencing current follow-up care practices among dermatologists included complying with patients' preferences, lack of trust in general practitioners (GPs), financial incentives and force of habit. Patients reported varying needs regarding periodic follow-up visits, preferred to be seen by a dermatologist and indicated a need for improved information provision. Suggested strategies by dermatologists to de-adopt the low-value care encompassed educating patients with improved information, educating GPs to increase trust of dermatologists, realizing appropriate financial reimbursement and informing dermatologists about the low value of care. CONCLUSIONS: A mixture of factors appear to contribute to current follow-up practices after low-risk BCC. In order to de-adopt this low-value care, strategies should be aimed at dermatologists and GPs, and also patients.

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  1. [1]Flohil SC, Koljenovic S, de Haas ER et al Cumulative risks and rates of subsequent basal cell carcinomas in the Netherlands. Br J Dermatol 2011; 165: 874– 81. 21711333
  2. [2]Hoorens I, Vossaert K, Ongenae K et al Is early detection of basal cell carcinoma worthwhile? Systematic review based on the WHO criteria for screening. Br J Dermatol 2016; 174: 1258– 65. 26872563
  3. [3]Ferrandiz L, Ruiz‐de‐Casas A, Trakatelli M et al Assessing physicians’ preferences on skin cancer treatment in Europe. Br J Dermatol 2012; 167 (Suppl. 2): 29– 35. 22881585
  4. [4]de Vries E, Misirli Y, Nijsten T et al Treatment and frequency of follow‐up of BCC patients in the Netherlands. J Eur Acad Dermatol Venereol 2018; 32: e351– 4. 29524257
  5. [5]Telfer NR, Colver GB, Morton CA. Guidelines for the management of basal cell carcinoma. Br J Dermatol 2008; 159: 35– 48. 18593385
  6. [7]Trakatelli M, Morton C, Nagore E et al Update of the European guidelines for basal cell carcinoma management. Eur J Dermatol 2014; 24: 312– 29. 24723647
  7. [8]Wammes JJ, van den Akker‐van Marle ME, Verkerk EW et al Identifying and prioritizing lower value services from Dutch specialist guidelines and a comparison with the UK do‐not‐do list. BMC Med 2016; 14: 196. 27884150 PMC5123317
  8. [9]Morgan DJ, Dhruva SS, Wright SM et al 2016 update on medical overuse: a systematic review. JAMA Intern Med 2016; 176: 1687– 92. 27654002 PMC5564394
  9. [10]Gnjidic D, Elshaug AG. De‐adoption and its 43 related terms: harmonizing low‐value care terminology. BMC Med 2015; 13: 273. 26486727 PMC4617953
  10. [11]Niven DJ, Mrklas KJ, Holodinsky JK et al Towards understanding the de‐adoption of low‐value clinical practices: a scoping review. BMC Med 2015; 13: 255. 26444862 PMC4596285
  11. [12]Garner S, Docherty M, Somner J et al Reducing ineffective practice: challenges in identifying low‐value health care using Cochrane systematic reviews. J Health Serv Res Policy 2013; 18: 6– 12. 23393036
  12. [13]Elshaug AG, Watt AM, Mundy L et al Over 150 potentially low‐value health care practices: an Australian study. Med J Aust 2012; 197: 556– 60. 23163685
  13. [14]Mitera G, Earle C, Latosinsky S et al Choosing Wisely Canada cancer list: ten low‐value or harmful practices that should be avoided in cancer care. J Oncol Pract 2015; 11: e296– 303. 25980018
  14. [15]Bower CP, Lear JT, de Berker DA. Basal cell carcinoma follow‐up practices by dermatologists: a national survey. Br J Dermatol 2001; 145: 949– 56. 11899149
  15. [17]Gosden T, Forland F, Kristiansen IS et al Capitation, salary, fee‐for‐service and mixed systems of payment: effects on the behaviour of primary care physicians. Cochrane Database Syst Rev 2000: CD002215. 10908531 PMC9879313
  16. [19]Mays N, Pope C. Rigour and qualitative research. BMJ 1995; 311: 109– 12. 7613363 PMC2550154
  17. [20]Patton MQ. Qualitative Research and Evaluation Methods, 3rd edn Thousand Oaks, CA: Sage Publications, 2001.
  18. [21]Kirkup ME, De Berker DA. Clinical measurement of dimensions of basal cell carcinoma: effect of waiting for elective surgery. Br J Dermatol 1999; 141: 876– 9. 10583170
  19. [23]Krabbe‐Alkemade YJFM, Groot TLCM, Lindeboom M. Competition in the Dutch hospital sector: an analysis of health care volume and cost. Eur J Health Econ 2017; 18: 139– 53. 26831045 PMC5313597
  20. [24]Fenton JJ, Kravitz RL, Jerant A et al Promoting patient‐centred counseling to reduce use of low‐value diagnostic tests: a randomized clinical trial. JAMA Intern Med 2016; 176: 191– 7. 26640973
  21. [25]Rosenbaum L. The whole ball game – overcoming the blind spots in health care reform. N Engl J Med 2013; 368: 959– 62. 23465107
  22. [26]Tilburt JC, Wynia MK, Sheeler RD et al Views of us physicians about controlling health care costs. JAMA 2013; 310: 380– 9. 23917288 PMC5553287
  23. [29]Nijkamp MD, Ruiter RAC, Roeling M et al Factors related to fear in patients undergoing cataract surgery: a qualitative study focusing on factors associated with fear and reassurance among patients who need to undergo cataract surgery. Patient Educ Couns 2002; 47: 265– 72. 12088605
  24. [30]de Jong JR, Vlaeyen JWS, Onghena P et al Fear of movement/(re)injury in chronic low back pain: education or exposure in vivo as mediator to fear reduction? Clin J Pain 2005; 21: 9– 17. 15599127
  25. [31]Kim JYS, Kozlow JH, Mittal B et al Guidelines of care for the management of basal cell carcinoma. JAMA Dermatol 2018; 78: 540– 59. 29331385
  26. [32]Henshall C, Schuller T, Mardhani‐Bayne L. Using health technology assessment to support optimal use of technologies in current practice: the challenge of ‘disinvestment’. Int J Technol Assess Health Care 2012; 28: 203– 10. 22792877
  27. [33]Absolom K, Eiser C, Michel G et al Follow‐up care for cancer survivors: views of the younger adult. Br J Cancer 2009; 101: 561. 19638979 PMC2736810
  28. [34]Birkhäuer J, Gaab J, Kossowsky J et al Trust in the health care professional and health outcome: a meta‐analysis. PLOS ONE 2017; 12: e0170988. 28170443 PMC5295692
  29. [35]Hollins J, Veitch C, Hays R. Interpractitioner communication: telephone consultations between rural general practitioners and specialists. Aust J Rural Health 2000; 8: 227– 31. 11894290
  30. [37]Shah H, Pozo‐Garcia L, Koulouroudias M. Dermatology – a compulsory part of the UK medical school curriculum? Med Educ Online 2015; 20: 30212. 26701607 PMC4689123
  31. [38]Hu A, Vender R. Undergraduate dermatology education in Canada: a national survey. J Cutan Med Surg 2018; 22: 31– 7. 28793799
  32. [39]Gupta A, Chong AH, Scarff CE et al Dermatology teaching in Australian medical schools. Australas J Dermatol 2017; 58: e73– 8. 27145418
  33. [40]Poelmann TA, van der Heide WK, Berendsen AJ. Skin tumours underexposed in general practice. Ned Tijdschr Geneeskd 2012; 156: A5279 (in Dutch). 23114178
  34. [43]Choudhry NK, Fletcher RH, Soumerai SB. Systematic review: the relationship between clinical experience and quality of health care. Ann Intern Med 2005; 142: 260– 73. 15710959
  35. [44]Zerr DM, Del Beccaro MA, Cummings P. Predictors of physician compliance with a published guideline on management of febrile infants. Pediatr Infect Dis J 1999; 18: 232– 8. 10093943
  36. [45]Niven DJ, Rubenfeld GD, Kramer AA et al Effect of published scientific evidence on glycemic control in adult intensive care units. JAMA Intern Med 2015; 175: 801– 9. 25775163
  37. [46]Stafford RS, Radley DC. National trends in antiobesity medication use. Arch Intern Med 2003; 163: 1046– 50. 12742801
  38. [47]Schwartz AL, Chernew ME, Landon BE et al Changes in low‐value services in year 1 of the Medicare pioneer accountable care organization program. JAMA Intern Med 2015; 175: 1815– 25. 26390323 PMC4928485
  39. [48]Roman BR, Asch DA. Faded promises: the challenge of deadopting low‐value care. Ann Intern Med 2014; 161: 149– 50. 24781317
  40. [49]Niven DJ, Leigh JP, Stelfox HT. Ethical considerations in the de‐adoption of ineffective or harmful aspects of healthcare. Healthc Manage Forum 2016; 29: 214– 17. 27498394
  41. [50]Rosenberg A, Agiro A, Gottlieb M et al Early trends among seven recommendations from the choosing wisely campaign. JAMA Intern Med 2015; 175: 1913– 20. 26457643
  42. [51]Chaix‐Couturier C, Durand‐Zaleski I, Jolly D et al Effects of financial incentives on medical practice: results from a systematic review of the literature and methodological issues. Int J Qual Health Care 2000; 12: 133– 42. 10830670
  43. [52]Hillman AL, Pauly MV, Kerstein JJ. How do financial incentives affect physicians’ clinical decisions and the financial performance of health maintenance organizations? N Engl J Med 1989; 321: 86– 92. 2733758
  44. [53]Kouides RW, Bennett NM, Lewis B et al Performance‐based physician reimbursement and influenza immunization rates in the elderly. Am J Prev Med 1998; 14: 89– 95. 9631159
  45. [54]Verkerk EW, Tanke MAC, Kool RB et al Limit, lean or listen? A typology of low‐value care that gives direction in de‐implementation. Int J Qual Health Care 2018; 30: 736– 9. 29741672 PMC6307334
  46. [55]Montini T, Graham ID. ‘Entrenched practices and other biases’: unpacking the historical, economic, professional, and social resistance to de‐implementation. Implement Sci 2015; 10: 24. 25889285 PMC4339245
  47. [56]Yardley L, Morrison L, Bradbury K et al The person‐based approach to intervention development: application to digital health‐related behavior change interventions. J Med Internet Res 2015; 17: e30. 25639757 PMC4327440
  48. [57]Lugtenberg M, Burgers JS, Han D et al General practitioners’ preferences for interventions to improve guideline adherence. J Eval Clin Pract 2014; 20: 820– 6. 24953439
  49. [58]Greenfield G, Foley K, Majeed A. Rethinking primary care's gatekeeper role. BMJ 2016; 354: i4803. 27662893
  50. [59]Yuan B, He L, Meng Q et al Payment methods for outpatient care facilities. Cochrane Database Syst Rev 2017; 3: CD011153. 28253540 PMC5449574
  51. [60]van Egmond S, Wakkee M, Droger M et al Needs and preferences of patients regarding basal cell carcinoma and cutaneous squamous cell carcinoma care: a qualitative focus group study. Br J Dermatol 2019; 180: 122– 9. 29927480

Cited by

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Authors
Egmond, S., Wakkee, M., Rengen, A., Bastiaens, M. T., Nijsten, T., & Lugtenberg, M.
Affiliations
  • Erasmus MC (NL)
  • Erasmus MC Cancer Institute (NL)
  • Department of Dermatology Mohs Klinieken Dordrecht the Netherlands
  • Elisabeth-TweeSteden Ziekenhuis (NL)
Corresponding author
Wakkee, M.
ORCID
Venue
British Journal of Dermatology
Publisher
Oxford University Press (OUP)
Published
2019-06
Volume
180
Issue
6
Pages
1420-1429
ISSN
  • 0007-0963 (ISSN-L)
  • 1365-2133
DOI
10.1111/bjd.17594
PMC
PMC6850416
OpenAlex
W2908184490
Cited by
11
References
3
Citations by year
2024: 2 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 1 · 2019: 1
FWCI
2.29
Type
journal article
Language
en
Open access
Licence
Locations
  • British Journal of Dermatology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • Research portal (Tilburg University) (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
  • RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
Funders
Ministerie van Volksgezondheid, Welzijn en Sport
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
  • Health Sciences › Medicine › Epidemiology › Nonmelanoma Skin Cancer Studies
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
Keywords
basal cell carcinoma, low-value care, follow-up care, de-implementation, dermatologists, general practitioners, patient preferences, patient information provision, financial incentives, trust in general practitioners, follow-up schedule, skin cancer surveillance
MeSH terms
Medical Overuse, Dermatologists, Adult, Aftercare, Aged, Attitude of Health Personnel, Basal Cell Carcinoma, Dermatology, Female, Humans, Male, Middle Aged, Practice Patterns, Physicians', Skin Neoplasms, Focus Groups, Practice Guidelines as Topic, Qualitative Research, Patient Preference, General Practitioners

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