Melanoma shared care. A tripartite approach for survival, the patient, their GP and their specialist (#201)
The combination of
the high incidence of melanoma in Australia and the increasing survival rates
(currently over 90%) means that there are increasing numbers of melanoma
survivors in the Australian population whose healthcare needs can be safely and
effectively provided using a shared care model. The project aim was to develop a model for
long term care of survivors of malignant melanoma, incorporating patient
self-management, general practice/specialist shared care, continuous supportive
care screening, patient and family centred long term care planning and
electronic reminders. Project
participants were melanoma survivors (n=104), completing evaluation of the
interventions at 3 months (3m n=44) and 9 months (9m n=34). All evaluations were completed using
SurveyMonkey® software. Resources developed for and evaluated by the project
participants included a personal melanoma diary, individualised risk stratified
shared care treatment and surveillance pathways, automated electronic self-examination
and supportive care reminders. An active learning module was designed to
further develop general practitioner (n=8) confidence to diagnose and manage
melanoma and survivorship issues in general practice. Personal utilisation of the diary was high
with over 70% utilisation recorded in both rounds of evaluation (3m n=34, 9m
n=28). Participants who valued the
information and resources provided (3m n=34, 9m n=28), participants who felt actively
involved in decisions regarding their care (3m n=35, 9m n=28). Using a likert scale, general practitioners
(n=7) evaluated the overall quality of education provided to them through their
participation in the melanoma active learning module as excellent. This pilot demonstrated that patients can be
fully educated regarding their individual prognosis and empowered to
confidently self-manage their survivorship needs, when provided with
individualised risk stratified surveillance plans and the engagement of general
practice in shared care arrangements.