The Utilization of Sunscreen Prescriptions to Increase Patient Use: Examination of Healthcare Provider Perceptions

 

James M. Roush, BSN, RN, Dr. Elizabeth A. Richards, PhD, MSN, RN, CHES, Dr. Katrina Masterson, DNP, RN, FNP-BC, DCNP, Dr. Janelle Potetz, DNP, RN, ANP-BC, CNE

 

Purdue University School of Nursing

502 N. University Street Johnson Hall of Nursing

West Lafayette, IN 47907

 

 

 

 

 

 

 

 

Significance and Problem Statement

            Each year an estimated three million people in the United States (U.S.) are treated for melanoma and non-melanoma skin cancers (Ruiz et al., 2019). These numbers have increased in recent decades with non-melanoma skin cancers equating to over ninety percent of skin cancer cases (Ruiz et al., 2019). Treatment costs currently average 8.1 billion dollars, representing over a one hundred percent increase since 2002 (AAD, 2021, Guy et al., 2015; Ruiz et al., 2019; Saes da Silva et al., 2018; Skin Cancer Foundation, 2021). A recent study found 56% of patients reported never receiving sunscreen counseling by a dermatologist or a primary care provider (Farberg, Rigel, & Rigel, 2016; Vasicek et al., 2018). Despite consistent research demonstrating the effectiveness of sunscreen in preventing deoxyribonucleic acid (DNA) damage from ultraviolet radiation when used properly, use of sunscreen remains low with less than 10% of men and 25% of women reporting regular application of sunscreen (Julian, 2019; Olsen et al., 2018; Zamoiski et al., 2015).

Applying prescriptions to help improve adherence to health behavior changes has been studied for several years. In 2003, a randomized controlled trial found those given a prescription for exercise showed greater improvement in important measures such as weight loss and blood pressure compared to the control group over a one-year period (Patrella et al., 2003). Further benefits of exercise prescriptions have been reported in more recent studies in which modest increases in physical activity were demonstrated (Orrow et al., 2012; O’Brien et al., 2017). Improved adherence to prescriptions has shown a decrease in mortality and an improvement in chronic disease outcomes; furthermore, lowering cost, increasing patient education, and finding ways to engage patients are all crucial in facilitating medication adherence (Neiman et al., 2018). While little research was found regarding sunscreen prescriptions, prescribing sunscreen in practice may provide a means by which conversation and education surrounding sunscreen and sun protective behavior is more likely to take place during office visits. This study seeks to investigate provider perceptions of using sunscreen prescriptions as a method to increase patient use.

Methodology

Due to lack of previous research studying providers’ perceptions of sunscreen prescriptions, it was necessary to look outside the research topic for a validated survey tool. This project measured provider perceptions of sunscreen prescriptions through use of a questionnaire originally developed to analyze provider attitudes pertaining to exercise prescriptions which demonstrated a high level of internal consistency (Smock & Chatfield, 2020). The modified questionnaire was reviewed by three experienced dermatology and internal medicine providers who gave suggestions to increase the content validity of the modified survey (see Appendix E). The questionnaire contained forty-six questions assessing providers’ perceptions of the following topics related to sunscreen prescriptions: efficacy, education, documentation, prescription practices, promotion, barriers and facilitation.

The questionnaire was sent to providers in dermatology, internal medicine, and family medicine. The survey was distributed through the Dermatology Nurses’ Association (DNA) and Society of Dermatology of Nurse Practitioners (SDNP). A convenience sample combined with snowballing technique was also utilized. Data was collected between March 2021 and June 2021. Quantitative data was evaluated using descriptive statistics via SPSS version 26. Descriptive statistics were employed to calculate the mean, standard deviation, minimum and maximum of Likert and one-to-ten scale questions. Further analysis using Independent-Samples T Test and One-Way ANOVA was used to assess for significant differences of means in participant responses when grouped by specialty and years of practice. Differenc">

title



The Utilization of Sunscreen Prescriptions to Increase Patient Use: Examination of Healthcare Provider Perceptions

 

 

 

 

 

 

The Utilization of Sunscreen Prescriptions to Increase Patient Use: Examination of Healthcare Provider Perceptions

 

James M. Roush, BSN, RN, Dr. Elizabeth A. Richards, PhD, MSN, RN, CHES, Dr. Katrina Masterson, DNP, RN, FNP-BC, DCNP, Dr. Janelle Potetz, DNP, RN, ANP-BC, CNE

 

Purdue University School of Nursing

502 N. University Street Johnson Hall of Nursing

West Lafayette, IN 47907

 

 

 

 

 

 

 

 

Significance and Problem Statement

            Each year an estimated three million people in the United States (U.S.) are treated for melanoma and non-melanoma skin cancers (Ruiz et al., 2019). These numbers have increased in recent decades with non-melanoma skin cancers equating to over ninety percent of skin cancer cases (Ruiz et al., 2019). Treatment costs currently average 8.1 billion dollars, representing over a one hundred percent increase since 2002 (AAD, 2021, Guy et al., 2015; Ruiz et al., 2019; Saes da Silva et al., 2018; Skin Cancer Foundation, 2021). A recent study found 56% of patients reported never receiving sunscreen counseling by a dermatologist or a primary care provider (Farberg, Rigel, & Rigel, 2016; Vasicek et al., 2018). Despite consistent research demonstrating the effectiveness of sunscreen in preventing deoxyribonucleic acid (DNA) damage from ultraviolet radiation when used properly, use of sunscreen remains low with less than 10% of men and 25% of women reporting regular application of sunscreen (Julian, 2019; Olsen et al., 2018; Zamoiski et al., 2015).

Applying prescriptions to help improve adherence to health behavior changes has been studied for several years. In 2003, a randomized controlled trial found those given a prescription for exercise showed greater improvement in important measures such as weight loss and blood pressure compared to the control group over a one-year period (Patrella et al., 2003). Further benefits of exercise prescriptions have been reported in more recent studies in which modest increases in physical activity were demonstrated (Orrow et al., 2012; O’Brien et al., 2017). Improved adherence to prescriptions has shown a decrease in mortality and an improvement in chronic disease outcomes; furthermore, lowering cost, increasing patient education, and finding ways to engage patients are all crucial in facilitating medication adherence (Neiman et al., 2018). While little research was found regarding sunscreen prescriptions, prescribing sunscreen in practice may provide a means by which conversation and education surrounding sunscreen and sun protective behavior is more likely to take place during office visits. This study seeks to investigate provider perceptions of using sunscreen prescriptions as a method to increase patient use.

Methodology

Due to lack of previous research studying providers’ perceptions of sunscreen prescriptions, it was necessary to look outside the research topic for a validated survey tool. This project measured provider perceptions of sunscreen prescriptions through use of a questionnaire originally developed to analyze provider attitudes pertaining to exercise prescriptions which demonstrated a high level of internal consistency (Smock & Chatfield, 2020). The modified questionnaire was reviewed by three experienced dermatology and internal medicine providers who gave suggestions to increase the content validity of the modified survey (see Appendix E). The questionnaire contained forty-six questions assessing providers’ perceptions of the following topics related to sunscreen prescriptions: efficacy, education, documentation, prescription practices, promotion, barriers and facilitation.

The questionnaire was sent to providers in dermatology, internal medicine, and family medicine. The survey was distributed through the Dermatology Nurses’ Association (DNA) and Society of Dermatology of Nurse Practitioners (SDNP). A convenience sample combined with snowballing technique was also utilized. Data was collected between March 2021 and June 2021. Quantitative data was evaluated using descriptive statistics via SPSS version 26. Descriptive statistics were employed to calculate the mean, standard deviation, minimum and maximum of Likert and one-to-ten scale questions. Further analysis using Independent-Samples T Test and One-Way ANOVA was used to assess for significant differences of means in participant responses when grouped by specialty and years of pr

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