Quality of Life Clinical Trial
Official title:
Buddy Relationships in DermatoloGic Excisions for Skin Cancer ("BRIDGES"): A Trial of One-to-one Peer Support in Patients With Facial Skin Cancers Treated With Mohs Surgery
More than 5 million skin cancer surgeries are performed each year in the United States with 80% of tumors appearing on the head and neck. Facial skin cancer diagnosis negatively affects patient quality of life (QOL) and treatment of skin cancer creates visible scars early in the postoperative period, increases anxiety, and impairs social interactions. We believe that these negative psychosocial changes represent an unmet need for additional social support and practical guidance. A one-to-one peer support program designed for skin cancer patients could provide a focused, cost-effective, patient-centered intervention to improve quality of life and increase satisfaction. Comparable one-to-one peer support programs have demonstrated high rates of patient satisfaction and positive QOL outcomes in a wide range of conditions. This prospective peer support program would be the first of its kind for melanoma and keratinocytic skin cancers. Our pilot program was designed in consultation with leading peer mentorship program researchers and we will implement a structured system to match volunteer mentors with patients. Through qualitative and quantitative data, we will evaluate the program's effect on patient QOL at 3 separate intervals: at initial consultation, 1-2 weeks post-surgery, and 3 months post-surgery. We hope that this study will enable us to design and execute a larger multi-center clinical trial in order to establish a best practice for surgeons to usher patients through the postoperative healing process after skin cancer surgery.
Skin cancer is a common, often chronic condition that negatively impacts patient quality of
life. Currently, more than 5 million skin cancer surgeries are performed in the United States
each year, at a cost of over $8 billion per year. Eighty percent of these tumors occur on the
head and neck, anatomic sites most visible to society. Recent studies have demonstrated that
patients have reduced concern about the severity and prognosis of their skin cancer in the
period immediately following Mohs micrographic surgery (MMS). However, patient QOL related to
appearance and social interactions is impaired in the weeks following MMS due to elevated
distress regarding post-surgical physical appearance.
One-to-one peer support programs benefit both the patient and the mentor. In one-to-one peer
support programs, individuals previously affected by a disease or condition volunteer to
provide support to current patients in a loosely structured, mentorship setting. Peer mentors
provide mentees with social and emotional support as well as practical guidance on health
system navigation. Similar peer mentorship programs with burn patients who had significant
changes to outward physical appearance resulted in positive experiences for both mentee and
mentor. Notable mentee feedback included the formation of an immediate connection with a peer
supporter and feelings of "automatic trust" even after previously seeing a mental health
professional for their care. Mentors described their participation in peer programs as a
source for continued learning and inspiration for their own recovery.
One-to-one peer support is a cost-effective, well-received intervention that increases
patient satisfaction and objective QOL measures across many fields. Outcome measurements of
one-to-one peer mentorship programs have demonstrated high rates of patient satisfaction and
positive psychological outcomes in patients suffering from diabetes, breast cancer, prostate
cancer, colon cancer, and gynecologic cancers. The operating cost of peer support mentorship
is low, and these programs can further relieve the health care system by reallocating access
to patient support services to a community level.
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