Exploring the burden of actinic keratoses through development of a patient decision aid: a mixed-methods study

Abstract

Abstract Background Actinic keratoses (AKs) are present on sun-exposed sites and are considered precursors of cutaneous squamous cell carcinoma. A better understanding of the experiences of patients with this condition may improve patient–provider relationships and guide the introduction of shared decision-making (SDM) to treatment decisions. Objectives To develop a patient decision aid (PDA) for field treatment of multiple AKs in line with the International Patient Decision Aid Standards (IPDAS) by (i) characterizing the burden and lived experiences of patients with multiple AKs, (ii) understanding the decisional needs of patients requiring field treatment, and (iii) exploring clinician preferences regarding field treatment for multiple AKs. Methods This mixed-methods study followed the most up-to-date guidelines set out by the IPDAS collaboration; a voluntary body that aims to enhance the quality of PDAs by developing an evidence-based systematic process for the development of unbiased and effective PDAs. Results Multiple AKs have a psychosocial impact on patients. Patients feel supported through the integration of evidence-based information to guide SDM. Conclusions We propose that the use of a PDA for multiple AKs provides a key role in supporting informed shared patient–provider decision-making and empowers patient involvement in their prospective treatment strategy.