Is sun protection education effective in transplant patients?

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Takeaway
  • Education can be effective at altering sun-protective behavior in transplant recipients, but no studies have yet linked it to decreasing rates of skin cancer.
Study design
  • Meta-analysis that included 7 studies (5 randomized controlled trials and 2 case series with a before-and-after design).
  • Educational strategies evaluated in these studies included a mobile app, a culturally sensitive workbook, 2 videos, and traditional verbal or written education during an outpatient visit.
  • Funding: No funding source disclosed.
Key results
  • None of the studies directly showed that sun protection educational interventions reduced the incidence of skin cancer posttransplantation.
  • Only 2 of the studies tried to show that an educational intervention led to a difference in sun damage or skin pigmentation, which is an objective intermediate measures of sun exposure.
  • 2 case series demonstrated that some sun-protective behaviors may improve with educational interventions, but the follow-up rates were 50% or lower for both studies and weakens their validity.
  • 1 paper found that the use of mailed reminders was effective in further increasing sun-protective behaviors when they were used to complement an in-office educational intervention.
Limitations
  • Small number of included trials.
  • Lack of patient-oriented evidence and reliance on self-reported behavior.
Why this matters
  • Transplant patients face a higher risk for skin cancer; these findings demonstrate the need for further research that will demonstrate whether behavioral counseling can directly decrease the incidence of skin cancer in this population.