The Influence of Supportive Oncodermatology Interventions on Patient Quality of Life: A Cross-Sectional Survey

May 2020 | Volume 19 | Issue 5 | Original Article | 477 | Copyright © May 2020

Published online April 17, 2020

Leora Aizman , Kamaria Nelson , Andrew D. Sparks , Adam J. Friedman

aThe George Washington University School of Medicine and Health Sciences, Washington, DC bDepartment of Dermatology, The George Washington Medical Faculty Associates, Washington, DC cDepartment of Surgery, The George Washington Medical Faculty Associates, Washington, DC

Abstract
Background: Dermatologic adverse events (dAEs) secondary to anticancer treatments reduce patients’ quality of life (QOL) and result in interruptions in anticancer therapy.
Objective: Determine if a comprehensive supportive oncodermatology program improves patients’ QOL scoring.
Methods: This was a cross-sectional survey of adult cancer patients enrolled in the George Washington University Supportive Oncodermatology Clinic. All patients were above age 18 years and received dermatologic care between May 1, 2017 and November 1, 2019. Fifty-five patents meeting inclusion criteria were invited to complete an online survey with questions adapted from the Dermatology Life Quality Index (DLQI) and Patient Satisfaction Questionnaire (PSQ-18).
Results: Survey initiation rate was 61.8% (34/55) and completion rate 88.2% (30/34). Average QOL score prior to treatment was 6.5 (moderate effect on QOL) and 3.8 (small effect) afterwards (P=0.0005; 95% CI -3.9 to -1.). Average satisfaction score was 4.15 ± 0.7 (satisfied). Impact on treatment adherence earned the lowest score (3.67, neutral to satisfied).
Limitations: Recall bias
Conclusion: Enrollment was significantly associated with improved QOL. Dermatologic care also resulted in overall satisfied patient outcomes, although many patients were unsure if these dermatologic interventions aided in anticancer treatment adherence, highlighting the need for evidence-based management strategies for dAEs.

J Drugs Dermatol. 2020;19(5):  doi:10.36849/JDD.2020.5040

INTRODUCTION

Supportive oncodermatology is a growing field that provides treatment and preventive care to oncology patients who experience dermatologic adverse events (dAEs) secondary to cytotoxic and targeted cancer treatments. Novel cancer therapies that impede the proliferation of cancer cells often target other rapidly proliferating organ systems and can lead to unfavorable skin, hair, and nail alterations. The most commonly documented dAEs include papulopustular rash, xerosis, pruritus, nail changes, chemotherapy-induced alopecia, and hand-foot skin reaction.1,2 Persistent dermatologic side effects may be disabling and are associated with negative psychosocial effects affecting patient confidence and functionality.3-6 Further, over 50% of cancer patients experience an interruption in therapy secondary to dAEs.7 With an estimated 1.8 million new cancer diagnoses made in 2019,8 all patients receiving anticancer therapy may be vulnerable to dAEs and the consequent impacts on wellness and treatment adherence.

DAEs caused by anticancer agents have been recognized since the beginning of the 20th century,1 yet there are limited evidence-based management guidelines. Comprehensive skin toxicity programs are currently being established with an overarching mission to improve patient QOL and optimize utilization of life-prolonging anticancer interventions. Although dermatologic health in cancer patients is gaining increasing attention,1 there are few studies evaluating the impact of supportive oncodermatology clinics on patient QOL. Additionally, there is a paucity of literature assessing patient satisfaction with supportive oncodermatology therapy at major academic centers.

In order to identify the impact that supportive oncodermatology therapy has on dermatology-related QOL, we performed a cross-sectional survey study of patients receiving care at the George Washington University (GWU) Supportive Oncodermatology Clinic. This urban, academic clinic launched in May 2017. This study also evaluated multiple dimensions of patient satisfaction with their received care.

METHODS

This cross-sectional survey study was approved by the George