Follow-up after low-risk basal cell carcinoma (BCC) is more frequently done than recommended by guidelines. Designing a pleasing strategy to reduce this ‘low-value’ care, demands insights into the preferences of patients and dermatologists.

A study determined the preferences and needs of patients and dermatologists to lower low-risk BCC follow-up care, and the exchanges they are willing to make, by creating a questionnaire including a discrete choice experiment, containing attributes regarding the amount of follow-up, continuity of care, method of providing additional information, type of healthcare provider, duration of follow-up visits and skin examination. 

371 BCC patients and all Dutch dermatologists and dermatology residents (n = 620) were given this questionnaire, which was further analyzed.

The following observations were made-

• 21% of the dermatologists and 72% of BCC patients completed the discrete choice experiment.
• The acceptance of having no additional follow-up visits (i.e. following the guidelines) tends to increase from 55% to 77% by patients if the post-treatment visit was performed by the same person as the treatment provider and a hand-out was provided to patients containing personalised information.
• Female patients and older dermatologists are less willing to accept the guidelines and favor extra follow-up visits.

This discrete choice experiment suggested a feasible approach to reduce costs, while maintaining the quality of care, based on the preferences and needs of BCC patients, which is reinforced by dermatologists.

Source- van Egmond S, de Vries E, Hollestein L, Bastiaens M, de Roos K-P, Kuijpers D, et al. What do patients and dermatologists prefer regarding low-risk basal cell carcinoma follow-up care? A discrete choice experiment. PLoS ONE, 2021; 16(3): e0249298. https://doi.org/10.1371/journal.pone.0249298