Predictors of treatment choices and associated outcomes in actinic keratoses: results from a national physician survey study.
OBJECTIVE
Actinic keratoses (AKs) are common skin lesions with the potential to progress to squamous cell carcinoma. Many effective treatment alternatives exist, yet the reasons for treatment choice have not been explored. This study examined which AK therapy was preferred among dermatologists and primary care physicians (PCPs), as well as potential determinants of therapeutic selection.


METHODS
A random national sample of 534 dermatologists and PCPs selected from the American Medical Association database completed AK questionnaires. The final sample included 1184 AK patients treated by dermatologists and 559 AK patients treated and/or referred by PCPs. All analyses were weighted using the survey sampling weights.


RESULTS
Patients who had new and recurring lesions as well as patients who had a mean duration of more than a year since the last AK episode treatment (all p<0.05) were more likely to receive pharmacotherapy. Patients being treated by a dermatologist, receiving pharmacotherapy treatment only, and having both new and recurring lesions (all p<0.05) were less likely to have a complete treatment success.


CONCLUSIONS
This study identifies several patient and physician factors associated with treatment preference and related outcomes in patients being treated for AK.
Balkrishnan
Rajesh
R
Departments of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA. balkrishnan.1@osu.edu
Cayce
Kimberly A
KA
Kulkarni
Amit S
AS
Orsagh
Thomas
T
Gallagher
Jack R
JR
Richmond
David
D
Feldman
Steven R
SR
D000368:Aged; D017679:Cryotherapy / Q000706:statistics & numerical data; D003880:Dermatology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007641:Keratolytic Agents / Q000627:therapeutic use; D007642:Keratosis / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D008297:Male; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D011795:Surveys and Questionnaires; D014481:United States
D007641:Keratolytic Agents