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#339 Improving patient counseling before and during imiquimod treatment for cervical high-grade squamous intraepithelial lesions: a qualitative study
  1. Caroline LP Muntinga1,
  2. Lotte HCJ Schellekens1,
  3. Charlotte Penders2,
  4. Peggy J De Vos Van Steenwijk2,
  5. Ruud LM Bekkers1 and
  6. Edith MGVan Esch1
  1. 1Catharina Hospital, Eindhoven, The Netherlands
  2. 2Maastricht University Medical Centre, Maastricht, The Netherlands


Introduction/Background Little is known about patient satisfaction with imiquimod treatment for cervical high-grade squamous intraepithelial lesions (cHSIL) and the impact of side effects and patient guidance during treatment. Since patient guidance varies between healthcare professionals and could influence patients’ motivation for treatment, the objective of this study was to discover if patient counselling and guidance before and during imiquimod treatment by gynaecologists and nurse practitioners could be improved, and in which way.

Methodology In this multicentre qualitative study, semi-structured interviews were conducted with patients treated with imiquimod for cHSIL, and with healthcare professionals from hospitals in the Netherlands who prescribe imiquimod. Patients were recruited at the outpatient clinics of hospitals in the Netherlands participating in the PRedICT-TOPIC trial. Healthcare professionals were recruited via e-mail. Interviews were transcribed and transcripts were analysed using thematic analysis by two members of the research team.

Results A total of 15 patients and 6 healthcare professionals were interviewed, which resulted in 4 main themes: counselling, side effects, use of imiquimod, and contact moments during treatment. Many patients believed that sharing patient experiences would help making treatment decisions. Some recommended additions to counselling, like providing detailed information on administration methods and side effect severity. Healthcare professionals agreed on the factors that need to be addressed during counselling but held different opinions on imiquimod’s side effect severity and administration methods.

Conclusion This study has shown that inadequate patient counselling and limited guidance during imiquimod treatment contribute to a more negative perception among patients and lead to an increased likelihood of early discontinuation of treatment, especially in the presence of adverse effects. To better prepare patients for the treatment, most importantly greater emphasis should be given to counselling of side effects of imiquimod, informing about the method of administration of imiquimod, and making patient experiences available for new patients.

Disclosures N/A.

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