The majority of MMS patients were found to not have completed all recommended follow-up visits the first two years following a diagnosis of non-melanoma skin cancer. Medicaid as one’s primary insurance and first-time MMS patients were the factors associated with lower adherence to follow-up visits.
Clinical Pearls
This retrospective chart review studied 385 patients treated with Mohs Micrographic Surgery (MMS) at Johns Hopkins University Hospital
Patient adherence to follow-up recommendations and factors associated with follow-up adherence were analyzed
The majority of MMS patients were found to not have completed all recommended follow-up visits the first two years following a diagnosis of non-melanoma skin cancer. Medicaid as one’s primary insurance and first-time MMS patients were the factors associated with lower adherence to follow-up visits.
Discussion:
In this retrospective analysis, Jinali et. al aim to evaluate the adherence of MMS patients to follow-up recommendations as well as factors associated with higher or lower levels of adherence. Data regarding demographic information, medical history, tumor and surgical characteristics, dates of follow-up visits, postoperative complications, and subsequent skin cancer diagnoses was collected for 385 patients who underwent MMS for non-melanoma skin cancer at Johns Hopkins Dermatology.
The majority of patients in this study did not complete all recommended follow-up visits in the first two years following diagnosis of a non-melanoma skin cancer. Moreover, 21.6% of patients did not undergo any follow-up dermatologic care two years following diagnosis. Interestingly, those who had lower follow-up adherence in this study were patients with Medicaid as their primary insurance (OR: 1.66, p=0.042) and first-time MMS patients (OR: 0.59, p<0.001). Factors associated with greater adherence were a prior history of non-melanoma skin cancer (OR: 1.58, p=0.001) and a history of a non-dermatologic solid tumor (OR: 1.66, p = 0.015).
Overall, this study provides insightful data suggesting follow-up adherence for Mohs micrographic surgery can be improved. Specifically, patients who are undergoing Mohs surgery for the first time and those who are insured through Medicaid were recognized at higher risk for decreased adherence. One limitation of this study is its generalizability as it was a single-institution study.
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