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Training leads to skin self-exams by patients with melanoma, partners

Patients with melanoma and their partners reliably performed skin self-examinations after participating in a structured skills training intervention, compared with controls who did not receive training, according to research recently published in JAMA Dermatology.

June K. Robinson, MD, of the department of dermatology, Northwestern University Feinberg School of Medicine, Chicago, and colleagues measured the effect of a structured skin self-exam intervention for patients with melanoma and their partners who were recruited from a Midwestern region through April 14, 2013.

June K. Robinson

The randomized clinical trial with 24-month follow-up assessments included patients with stage 0 to IIB melanoma and their skin-check partners who participated from June 6, 2011, to April 24, 2015.

There were 494 patients (51.2% female; mean age, 55 years) in the study, who with their partners were classified “dyads,” and randomly assigned to one of four groups: in-person intervention in the office; intervention with a workbook read in the office and taken home; intervention using a small tablet person computer in the office; and controls, who received customary education. Reinforcement was provided every 4 months by a study dermatologist.

There were significantly increased skin self-exams among the patients and partners in the three intervention arms compared with controls at 4 months (mean difference, 1.57; 95% CI, 1.29-1.85), 12 months (mean difference, 0.72; 95% CI, 0.39-1.06) and 24 months (mean difference, 0.94; 95% CI, 0.58-1.3).

“Patients in the intervention arms identified new melanomas more than those in the control group (n = 51 melanomas in situ; n = 18 invasive melanomas) and did not increase physician visits,” the researchers wrote.

 “Patients with melanoma and their partners reliably performed [skin self-exams] after participating in a structured skills training program lasting approximately 30 minutes, with reinforcement every 4 months by the study dermatologist,” the researchers concluded. “Future research will determine if a skills training program delivered via the web without reinforcement by a dermatologist will yield reliable sustained performance of [skin self-exams] by those at risk to develop another melanoma.” – by Bruce Thiel

Disclosure: The research initiative was funded by grant R01 CA154908 from the National Cancer Institute; however, the funding agency reportedly had no involvement in the development or submission of the manuscript. Robinson reports being the editor of JAMA Dermatology, but was not involved in the editorial review or the decision to accept the manuscript for publication. See the full study for other researchers’ relevant financial disclosures.