In the JournalsPerspective

Personalized advice improves sun protection among patients

Patients who received individualized advice directly from their general practitioner improved their sun protection, according to findings from a randomized controlled study.

“Skin cancers are the most rapidly increasing cancer forms in many western societies. As a consequence, the first line of care providers (in most cases primary care/the general practitioner/family physician) need to be appropriately prepared to be able to more efficiently handle the increasing number of patients in need of having a skin check, but also to act preventively towards the disease,” Magnus Falk, MD, PhD, associate professor in the division of community medicine and primary care at Linköping University in Sweden, told Healio Primary Care.

“Since lifestyle counseling is one of the major tasks commonly performed in primary care, targeting various diseases or risk factors, we considered it to be of great interest and importance to investigate whether sun protection advice would in reality appear to be beneficial and worthwhile, in a long enough perspective,” he continued.

Falk and colleagues randomly assigned more than 300 participants to one of three intervention groups. In group one, the general practitioner sent a letter detailing how the patient could increase their sun protection (n = 116). In group two, the clinician verbally conveyed similar information (n = 97). In group three, the general practitioner orally discussed sun protection tips, and the patient also underwent a skin ultraviolet-sensitivity photo test (n = 96). The baseline questionnaire was administered again after 3 and 10 years.

Researchers observed statistically significant declines in all groups in the mean scores for sun exposures over time. In addition, a significantly greater decrease in mean score occurred in the second and third groups vs. the first group (P < .01). The skin ultraviolet-sensitivity photo test had no impact on that intervention’s success.

“The results indicate that sun protection advice to reduce skin cancer risk may be of just as natural significance to communicate in primary care as other common lifestyle counseling (eg, physical activity or tobacco use),” Falk said in the interview.

Falk said larger multicenter studies are needed validate the findings before they can be implemented in a primary care setting.

“The shortage of time and personnel resources constitute the major barrier to implementation, since the demands on primary care physicians tend to continuously increase. If repeated studies can provide a strong evidence for sun protection advice to be beneficial, the investment in a potential decline in future skin cancer incidence would justify the increased resources possibly needed to achieve it,” he said. – by Janel Miller

Disclosures: The authors report no relevant financial disclosures.

Patients who received individualized advice directly from their general practitioner improved their sun protection, according to findings from a randomized controlled study.

“Skin cancers are the most rapidly increasing cancer forms in many western societies. As a consequence, the first line of care providers (in most cases primary care/the general practitioner/family physician) need to be appropriately prepared to be able to more efficiently handle the increasing number of patients in need of having a skin check, but also to act preventively towards the disease,” Magnus Falk, MD, PhD, associate professor in the division of community medicine and primary care at Linköping University in Sweden, told Healio Primary Care.

“Since lifestyle counseling is one of the major tasks commonly performed in primary care, targeting various diseases or risk factors, we considered it to be of great interest and importance to investigate whether sun protection advice would in reality appear to be beneficial and worthwhile, in a long enough perspective,” he continued.

Falk and colleagues randomly assigned more than 300 participants to one of three intervention groups. In group one, the general practitioner sent a letter detailing how the patient could increase their sun protection (n = 116). In group two, the clinician verbally conveyed similar information (n = 97). In group three, the general practitioner orally discussed sun protection tips, and the patient also underwent a skin ultraviolet-sensitivity photo test (n = 96). The baseline questionnaire was administered again after 3 and 10 years.

Researchers observed statistically significant declines in all groups in the mean scores for sun exposures over time. In addition, a significantly greater decrease in mean score occurred in the second and third groups vs. the first group (P < .01). The skin ultraviolet-sensitivity photo test had no impact on that intervention’s success.

“The results indicate that sun protection advice to reduce skin cancer risk may be of just as natural significance to communicate in primary care as other common lifestyle counseling (eg, physical activity or tobacco use),” Falk said in the interview.

Falk said larger multicenter studies are needed validate the findings before they can be implemented in a primary care setting.

“The shortage of time and personnel resources constitute the major barrier to implementation, since the demands on primary care physicians tend to continuously increase. If repeated studies can provide a strong evidence for sun protection advice to be beneficial, the investment in a potential decline in future skin cancer incidence would justify the increased resources possibly needed to achieve it,” he said. – by Janel Miller

Disclosures: The authors report no relevant financial disclosures.

    Perspective
    Bruce Brod

    Bruce Brod

    The study by Hedevik and colleagues was done in one town, so this study is not necessarily scalable. This will hopefully encourage other similar studies of interventions among other cohorts to determine its practicality across more primary care settings.

    Behavioral health economists teach us that people do not always behave rationally when it comes to health care, but the behavior is still predictable, and we can use interventions to shape their decisions. We know from experience that there are many ways to nudge patients in the right direction. As physicians, we need to know and understand our patients well enough to know what interventions would work best for them. This study can serve as a motivation for other physicians to test and iterate treatment interventions in their practices.

    So to me, the take-home message from this study is that primary care physicians should always be thinking about how behavioral health and economically feasible interventions can be used to come up with solutions to improve outcomes. PCPs should also be thinking about how they can creatively use incentives to positively influence patient behavior.

    • Bruce Brod, MD
    • Director, Occupational and Contact Dermatitis Clinic Chief of dermatology, Pennsylvania Hospital Penn Medicine

    Disclosures: Brod reports no relevant financial disclosures.