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Experience of implementing a value-based approach in oncodermatology


Objective: implementation of value-based approach and development of adherence to treatment in patients with non-melanoma cancer.

Material and methods. The observational, single-arm, prospective, long-term single-center study of the quality of life and patients’ experience was performed. It included 42 patients aged from 42 to 82 years. Validated questionnaires were used: Patient-Reported Outcome Measures (PROMs) (as a decision support tool), Patient-Reported Experience Measures (PREMs) (3 months after treatment to assess the patient's experience).

Results. Mean concern about appearance was 43.5 points (Rasch psychometric model). Younger patients (r=–0.398, p=0.009) and female patients (r=–0.475, p=0.001) were more concerned about appearance. In 10 cases (24%), the involvement was estimated as 4 points, in 18 cases (43%), it was 3 points, in 14 cases (33%), it was 2 points. Older patients were less involved in the choice of treatment method (r=–0633, p<0.001). The level of satisfaction with communications was more than 50 points. The use of a patient-oriented algorithm of communication has a positive effect on a patient's experience.

Conclusion. The heads of oncological care are recommended to evaluate the patient's experience on a regular basis, create conditions for patients to choose treatment methods according to their individual needs, analyze the outcomes obtained by the introduction of validated questionnaires on the appropriate nosological profile and take these results into account in treatment. Further studies of the degree of influence of different factors on a patient’s choice of treatment method are needed, as well as conducting studies among other groups of patients with non-melanoma skin cancer (located in other parts of the body, larger than 2 cm).

About the Authors

Yu. A. Zuenkova
Peoples’ Friendship University of Russia
Russian Federation

Yulia А. Zuenkova – Master of Business Administration, Faculty Member, Chair of Healthcare Organization, Drug Provision, Medical Technologies and Hygiene, Faculty of Continuing Medical Education, Medical Institute. Scopus Author ID: 57223995388; RSCI SPIN-code: 2046-3170

6 Miklukho-Maklay Str., Moscow 117198

D. I. Kicha
Peoples’ Friendship University of Russia
Russian Federation

Dmitriy I. Kicha – Dr. Med. Sc., Professor, Chair of Health Сare Organization, Drug Provision, Medical Technologies and Hygiene, Professor, Chair of Public Health, Health Care and Hygiene, Faculty of Continuing Medical Education, Medical Institute. RSCI SPIN-code: 5622-0128

6 Miklukho-Maklay Str., Moscow 117198

L. N. Izyurov
Sverdlovsk Regional Oncological Dispensary
Russian Federation

Lev N. Izyurov – MD, PhD, Radiotherapist

29 Sobolev Str., Ekaterinburg 620036


1. Porter M.E., Teisberg E.O. Redefining health care: creating value-based competition on results. 1st ed. Harvard Business School Press; 2006: 528 pp.

2. Porter M.E. What is value in health care? New Engl J Med. 2010; 363(26): 2477–81.

3. Implementing value-based health care in Еurope: handbook for pioneers. EIT Health; 2020. Available at: (accessed 27.01.2022).

4. Greenhalgh T. How to read a paper: the basics of evidence-based medicine. 5th ed. BMJ Books; 2014: 284 pp.

5. Elwyn G., Edwards A.G., Kinnersley P., Grol R. Shared decision making and the concept of equipoise: the competences of involving patients in healthcare choices. Br J Gen Pract. 2000; 50 (460): 892–9.

6. Coulter A., Collins A. Making shared decision making a reality. No decision about me, without me. The Kings Fund; 2011. Available at: (accessed 27.01.2022).

7. Cooper-Patrick L., Gallo J.J., Gonzales J.J., et al. Race, gender, and partnership in the patient-physician relationship. JAMA. 1999; 282 (6): 583–9.

8. Thompson T.L., Dorsey A., Parrott R., Miller K. (Eds.) Handbook of health communication. 1 st ed. Routledge; 2003: 63–9.

9. Cegala D.J. An exploration of factors promoting patient participation in primary care medical interviews. Health Commun. 2011; 26 (5): 427–36.

10. Street R.L. Jr., Gordon H.S., Ward M.M., et al. Patient participation in medical consultations: why some patients are more involved than others. Med Care. 2005; 43 (10): 960–9.

11. Rangarajan R., Jayaraman K. Barriers affecting adherence to radiation treatment and strategies to overcome those barriers. Ind J Cancer. 2017; 54 (2): 458–60.

12. Elwyn G., Hutchings H., Edwards A., et al. The OPTION scale: measuring the extent that clinicians involve patients in decision-making tasks. Health Expect. 2005; 8 (1): 34–42.

13. National Institute for Health and Care Excellence (NICE). Shared decision making. NICE Guideline [NG197]. 17 June 2021. Available at: (accessed 27.01.2022).

14. Khazaei Z., Ghorat F., Jarrahi A., et al. Global incidence and mortality of skin cancer by histological subtype and its relationship with the human development index (HDI); an ecology study in 2018. World Cancer Res J. 2019; 6.

15. Kaprin A.D., Starinskiy V.V., Shakhzadova A.O. (Eds.) Malignant neoplasms in Russia in 2019 (morbidity and mortality). Мoscow; 2020: 252 pp. (in Russ.).

16. Izurov L.N., Zuenkova J.A. Forecasting and optimization of the kilovoltage X-ray therapy office within the framework of clinical guidelines of the Association of oncologists of Russia (AOR) of the Ministry of Нealth of the Russian Federation. Research and Practical Medicine Journal. 2020; 7 (3): 99–107 (in Russ.).

17. Decree of the Government of the Sverdlovsk Region of 28.06.2019 No. 310-RP “On approval of the program “Fight against oncological diseases in the Sverdlovsk Region for 2019–2024”. Available at: (in Russ.) (accessed 27.01.2022).

18. Basal cell skin cancer. Clinical guidelines. 2020. Available at: (in Russ.) (accessed 27.01.2022).

19. Squamous cell skin cancer. Clinical guidelines. 2020. Available at: (in Russ.) (accessed 27.01.2022).

20. Tarnawski R., Fowler J., Skladowski K., et al. How fast is repopulation of tumor cells during the treatment gap? Int J Radiat Oncol Biol Phys. 2002; 54 (1): 229–36.

21. Dale R.G., Hendry J.H., Jones B., et al. Practical methods for compensating for missed treatment days in radiotherapy, with particular reference to head and neck schedules. Clin Oncol (R Coll Radiol). 2002; 14 (5): 382–93.

22. Martens R.M., Koopman T., Noij D.P., et al. Adherence to pretreatment and intratreatment imaging of head and neck squamous cell carcinoma patients undergoing (chemo) radiotherapy in a research setting. Clin Imaging. 2021; 69: 82–90.

23. Zuenkova Yu.A., Kicha D.I., Abramov A.Yu., et al. Patientoriented algorithm for the X-ray therapy cabinet of oncology dispensary. Medical Radiology and Radiation Safety. 2021; 66 (5): 45–9 (in Russ.).


For citations:

Zuenkova Yu.A., Kicha D.I., Izyurov L.N. Experience of implementing a value-based approach in oncodermatology. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2022;15(2):250-258. (In Russ.)

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