Shared medical appointment for early stage melanoma survivorship.

Abstract

69 Background: Shared medical appointments (SMA) are a newer patient care format that involve both education and creation of individualized medical plans for multiple patients in a group setting. SMAs have been found to be cost-effective with high patient satisfaction scores. Methods: We describe an SMA model for early stage melanoma surveillance. The development of our SMA required multidisciplinary input from oncology, psychology, social work, schedulers, business, nursing and cancer center administration. We emphasized creation of a nonjudgmental environment to educate and promote healthy behavior. Results: Our early stage melanoma SMA involves 4-6 patients with an APP as group leader, RN as facilitator, and PsyD to provide psychosocial support. The 90-minute visit starts with a private physical exam followed by group education, activities, and formation of an individualized surveillance plan. An integral component of our SMA is the use of a self-assessment Melanoma Risk tool that has been found to be an efficient method to promote sun protective behaviors. Patients self-identify behavioral risks and personalize strategies to combat long-term effects of unhealthy behaviors. Psychosocial aspects are monitored with the NCCN distress management tool to identify areas of distress. The primary goals of care are to diminish isolation, enhance self-management, and provide professional expertise in combination with first-hand information from peers. Long-term goals are to decrease anxiety and increase survival with prevention. Conclusions: The first project to our knowledge utilizing an SMA format for cancer surveillance, this effort identifies a population at risk and provides education and psychosocial support to change high-risk behaviors. Future areas of research include quantifying outcomes of SMA-based surveillance and the addition of significant others to enhance surveillance.