The Experience of Melanoma Follow-Up Care: An Online Survey of Patients in Australia

Investigating patients’ reports on the quality and consistency of melanoma follow-up care in Australia would assist in evaluating if this care is effective and meeting patients’ needs. The objective of this study was to obtain and explore the patients’ account of the technical and interpersonal aspects of melanoma follow-up care received. An online survey was conducted to acquire details of patients’ experience. Participants were patients treated in Australia for primary melanoma. Qualitative and quantitative data about patient perceptions of the nature and quality of their follow-up care were collected, including provision of melanoma specific information, psychosocial support, and imaging tests received. Inconsistencies were reported in the provision and quality of care received. Patient satisfaction was generally low and provision of reassurance from health professionals was construed as an essential element of quality of care. “Gaps” in follow-up care for melanoma patients were identified, particularly provision of adequate psychosocial support and patient education. Focus on strategies for greater consistency in the provision of support, information, and investigations received, may generate a cost dividend which could be reinvested in preventive and supportive care and benefit patient well-being. 1. Introduction Globally, Australia has the highest incidence of melanoma, with annual rates continuing to rise [1]. Individuals with a primary melanoma have 8–12% risk of developing a second primary melanoma and an increased risk of developing a nonmelanoma skin cancer [2–5], and therefore posttreatment monitoring for recurrence and new primary melanomas is important. The purpose of follow-up is to detect recurrence and/or progression at an early treatable stage, identify treatment-related morbidity (e.g., lymphoedema), identify new melanoma or nonmelanoma skin cancers, and provide reassurance and education [6]. Good practice in follow-up includes effective coordination of care, consistency in care provision [7, 8], evidence-based testing, and psychosocial support [6–9]. Patient perceptions can provide valuable insight into the quality of melanoma follow-up care and identify potential areas for improvement. Quality of patient care can be defined in both technical and interpersonal terms [10]. Here, “technical” refers to best practice based on current evidence coupled with care providers’ knowledge, judgment, and skill in implementation [10]. The 2008 Australian Cancer Network Melanoma Guidelines publication describes best practice guidelines for melanoma