Patients at elevated risk of melanoma: Individual predictors of non-compliance to GP referral for a dermatologist consultation |
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| Affiliation: | 1. Department of General Practice, Faculty of Medicine, Nantes, France;2. Onco-dermatology Department, Nantes University Hospital, France;3. Department of Epidemiology and Biostatistics, Nantes University Hospital, France;4. French National Institute of Health and Medical Research (INSERM U892)/National Center for Scientific Research (CNRS U6299)—team 2, France;5. Department of Social Studies, Faculty of Medicine, Nantes, France;1. School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China;2. Department of Health, Government of Hong Kong SAR, Hong Kong, China;3. City University of New York , School of Public Health and Hunter College, NY, USA;1. Research Centre in Epidemiology and Preventive Medicine, Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy;2. Istituto Superiore di Sanità, Roma, Italy;3. Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;4. IRCCS Istituto Auxologico Italiano and University of Milano-Bicocca, Milano, Italy;5. Research Center for Public Health, University of Milano-Bicocca, Monza, Italy;1. Alfred Deakin Research Institute, Deakin University Waterfront Campus, Geelong, Victoria 3220, Australia;2. Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, PO Box 7343, Wellington, New Zealand;3. University of Otago, Dunedin, New Zealand |
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| Abstract: | ObjectiveThe aim of this study is to assess whether patients at elevated risk of melanoma attended a dermatologist consultation after a General Practitioner referral and to determine individual predictors of non-compliance.MethodThis survey included 1506 high-risk French patients (selected using the Self-Assessment Melanoma Risk Score) referred to a dermatologist between April and October 2011.Compliance was evaluated from January to April 2012, based on attendance at a dermatologist consultation (or scheduling an appointment).Demographic data and factors mapping the Health Belief Model were tested as correlates using a multivariate logistic regression.ResultsCompliance with referral was 58.4%. The top seven factors associated with non-compliance were as follows: GP advice to consult was unclear (OR = 13.22; [7.66–23.56]); no previous participation in cancer screenings, including smear tests (OR = 5.03; [2.23–11.83]) and prostate screening (OR = 2.04; [1.06–3.97]); lack of knowledge that melanoma was a type of cancer (OR = 1.94; [1.29–2.92]); and reporting no time to make an appointment (OR = 2.08; [1.82–2.38]), forgetting to make an appointment (OR = 1.26; [1.08–1.46]), long delays in accessing an appointment (OR = 1.25; [1.12–1.41]), not being afraid of detecting something abnormal (OR = 1.54; [1.35–1.78]), no need to consult a dermatologist to feel secure (OR = 1.28; [1.09–1.51]).ConclusionPhysicians should be aware of the factors predicting patient compliance with referrals for dermatologist consultations; better General Practitioner counseling might enhance compliance in high-risk populations. |
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