Дистанционные программы активации пациентов повышают частоту само- и врачебных осмотров кожи у реципиентов трансплантации

Remotely delivered interventions increase rates of skin self-examination by recipients of hematopoietic cell transplantation (HCT), according to research published in the Journal of the National Comprehensive Cancer Network. Coupled with interventions to increase physician involvement, the use of these remote interventions also leads to more physician-performed skin cancer screenings, study researchers reported. The TEACH study (NCT04358276) included 720 adult recipients of HCT. The median age of the participants was 61.0 years, and 59% were male. More than half of participants (58%) reported having fair or very fair skin. The median time from HCT was 3.1 years; 55% of participants had undergone autologous HCT and 45% had undergone allogeneic HCT. The patients were randomly assigned to 1 of 2 study arms. One arm received an intervention of patient activation and education (PAE), which included remotely delivered print materials, plus 12 text messages at 3-week intervals for 9 months. The other arm was given PAE plus physician activation, which involved providers receiving educational materials and guidance on skin examinations. At 12 months, the rate of the combined outcome of skin self-examination and physician-performed skin examination increased in both arms. In the PAE-only arm, the percentage of participants reporting both skin self-examination and physician skin examination increased from 15.8% at baseline to 47.5% at follow-up (odds ratio [OR], 4.98; 95% CI, 3.54-7.02). For the arm that received PAE plus physician activation, these proportions were 18.0% at baseline and 52.1% at follow-up (OR, 5.49; 95% CI, 4.03-7.50). The difference between the arms was not significant (P =.25). For skin self-examination rates alone, the PAE-only arm showed an increase from 34.7% at baseline to 81.5% at follow-up (OR, 8.45; 95% CI, 6.03-11.82), and the PAE plus physician activation arm experienced an increase from 31.5% to 79.0% (OR, 8.39; 95% CI, 6.16-11.44). Again, there was no significant difference between arms (P =.52). For physician-performed skin examinations alone, however, the increase over time was from 32.1% at baseline to 55.3% at follow-up for the PAE-only arm (OR, 2.82; 95% CI, 2.10-3.78) and 33.2% to 64.8% for the arm that also had physician activation (OR, 4.34; 95% CI, 3.22-5.85), a significant difference (P =.01). The mean number of body regions self-examined was 2.7 at baseline and 5.8 at follow-up (OR, 2.12; 95% CI, 1.87-2.39) for the PAE-only arm, and 2.4 at baseline and 5.8 at follow-up (OR, 2.42; 95% CI, 2.13-2.74) for the physician activation arm, with no significant difference between arms (P =.46). Based on participant responses, skin cancer-specific knowledge and risk awareness improved in each arm, the researchers noted. In an exploratory analysis of participant self-reports, by the 12-month follow-up, clinical skin examination had reportedly been undergone by 174 individuals in the PAE-only arm and 228 individuals in the physician activation arm, with biopsy undergone by 39 and 45 individuals, respectively. A cancer diagnosis was received by 17 individuals and 13 individuals, respectively. “This study demonstrates that remotely delivered patient activation and education, requiring modest resources, can meaningfully improve skin cancer screening among HCT survivors,” the researchers concluded. “The addition of physician-directed components further increased physician-performed screening, underscoring the importance of clinician engagement in promoting preventive behaviors.” Disclosures: This research was supported by the National Cancer Institute. Some study authors disclosed conflicts of interest. Please see the original reference for complete disclosures. References: Armenian SH, Du X, Bosworth A, et al. Technology-enabled patient and physician activation to enhance skin cancer screening after HCT: A randomized controlled trial. J Natl Compr Canc Netw. Published online August 6, 2026. doi:10.6004/jnccn.2026.7030