Study of compliance with follow-up in melanoma patients

Laura Baumel, Aline Van Maanen, David Ogez, Isabelle Tromme Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Summary :


Melanoma is associated with a high risk of recurrence and new primaries. A lifelong follow-up is thus recommended. This study was aimed at identifying the factors that could influence the patient’s compliance with dermatological and oncological follow-up.



Data from the King Albert II Institute were used to generate an initial sample of 396 patients who had been diagnosed with melanoma between 01/01/2004 and 31/12/2008. Patients presenting with a recurrence or second primary tumor during the study period, as well as those who died, were lost to followup, refused taking part, did not consult in our institution, were minor when diagnosed with melanoma, suffered from dementia or had a wrong diagnosis in the King Albert II Institute’s database were excluded. Remaining patients were divided into three categories: patients who had attended follow-up for less than 4 years after diagnosis (“very early withdrawal”), patients who had attended follow-up for more than 4 years but less than 8 years after diagnosis (“early withdrawal”), and patients who had attended follow-up for at least 8 years (“late withdrawal” or “no withdrawal”). A survey consisting of four questionnaires assessing sociodemographic characteristics, relationship with medical staff quality, coping strategies, and anxiety, respectively, was sent to participating patients.



Based on our exclusion criteria, 210 patients were excluded and 186 were included in the study. Among them, 138 patients were compliant with follow-up, 35 were early withdrawers, and 13 were very early withdrawers. The number of risk factors for melanoma and the quality of the relationship with medical staff were significantly associated with improved compliance with follow-up (p<0.05). The use of palliative coping strategies was significantly associated with worse compliance (p<0.05). Satisfaction regarding medical information provided at diagnosis was a statistically significant factor in univariate logistic regression analysis (p<0.05) and was strongly correlated with the quality of the relationship with the medical staff in multivariate logistic regression analysis (Spearman’s rank correlation coefficient r=0.637).



Overall, this study demonstrated a very high rate of compliance with melanoma follow-up. The results suggest that increased attention should be paid to patients with multiple melanoma risk factors who must be sensitized to the risk of second primary tumor in order to stimulate their compliance. The quality of the medical staff-patient relationship, notably through suitable information, also contributes to the patient’s compliance with follow-up. Furthermore, patients using palliative coping strategies should be identified, as they were found to be less compliant.