Improving outcomes for people with skin tumours including melanoma

One RCT conducted with patients with melanoma found that a 6-
week structured psychiatric group intervention improved patients’
affective states and coping styles at 6 weeks follow-up and at 6
months follow-up.
Improving Outcomes for
People with Skin Tumours
including Melanoma
Patient-centred care
One RCT conducted with patients with melanoma found that a 6-
week, structured psychiatric group intervention, which included
health education, was associated with a survival advantage, after
adjusting for gender and Breslow thickness.
Evidence from systematic reviews and meta-analyses suggests that
psychological, educational and supportive interventions are beneficial
for patients with cancer.
Effectiveness of patient feedback
2
Evidence from an observational study suggests that patients with
cancer who respond to questionnaire surveys are younger and
experience fewer illness-related problems than patients who do not
respond. Two expert reviews reported that rigorously designed
patient-satisfaction questionnaires can bring about improvement in
service provision, in terms of better implementation of guidelines,
improvement of safety and increased patient satisfaction.
Clinical trials
One high-quality systematic review investigated patient outcomes
related to mortality and morbidity among participants and nonparticipants
in clinical trials. RCTs of different specialities were
included, but the largest proportion was of patients with cancer. The
review found little evidence for better outcomes through participation
in trials aside from those arising from the effects of the treatments
compared, or differences between participants and non-participants.
The same review found no evidence of greater risk arising from trial
participation.
A previous, poorer-quality systematic review than the one cited above
examined evidence for better patient outcomes through RCT
participation. The majority of RCTs were of patients with cancer. The
review concluded that it is likely that clinical trials have a positive,
rather than a negative, effect on survival and morbidity outcomes,
with benefits arising from the use of trial protocols.
One literature review found that children and adolescents with
melanoma are not entered into clinical trials. Retrospective studies
have found that adolescents with cancer are not as likely to be
entered into clinical trials as children and adults.
Guidance on cancer services: skin tumours including melanoma
41