Efficacy of an educational intervention with kidney transplant recipients to promote skin self-examination for squamous cell carcinoma detection

Abstract

Objectives: To develop easily disseminated educational materials that enable early detection of skin cancer, and to examine the effectiveness of the materials to promote skin self-examination (SSE) among kidney transplant recipients (KTRs).

Design: Randomized controlled trial of an educational intervention in comparison with a group that received only the assessment, education, and treatment as part of usual care with a nephrologist.

Setting: Academic ambulatory nephrology practice.

Patients: Seventy-five KTRs returning for routine care to their nephrologists 1 to 1.2 years or 3 to 7 years after transplantation.

Intervention: Educational workbook.

Main outcome measures: Skin self-examination performance and new appointments with a dermatologist if a concerning skin lesion was found.

Results: Twenty-two percent of those in the control group checked their skin after the visit compared with 89% of the treatment condition; thus, KTRs receiving the intervention were significantly more likely to have checked their skin (χ(2); P < .001). Among the 8 control KTRs who checked their skin, none found areas of concern. Of the 34 intervention KTRs who checked their skin, 12 participants (35%) found areas of concern. All 12 of these individuals made appointments with a dermatologist for follow-up.

Conclusions: The KTRs were receptive to performing SSE and acted on the recommendation made in the workbook to make an appointment with a dermatologist when a concerning lesion was discovered. Printed educational materials can be initiated in the tertiary care center 1 year after transplantation and used across a continuum of time during which KTRs may be transferred from the tertiary care center to community nephrologists.

Trial registration: clinicaltrials.gov Identifier: NCT01127737.

Figures

Figure

REACT mnemonic provides illustrations of the warning signs of squamous cell carcinoma and advises when to seek health care. See the “Development of Mnemonic” subsection in the “Methods” section.