Patient Satisfaction with Dermoscopy Use: A Cross-Sectional Study of 121 Patients

Dear Editor, Dermoscopy is increasingly gaining interest as a valuable non-invasive tool in the diagnosis and management of various neoplastic and non-neoplastic dermatological diseases. It increases the diagnosis accuracy of dermatoses, and also the physician’s confidence.[1] Using skin imaging can be an essential way to assure the quality of the services provided in the dermatologic consultation for the fulfillment of patients’ expectations and needs. The physician-patient interaction is not only a crucial component of high-quality healthcare, trustworthy physician-patient relationships are also linked to increased information disclosure, patient adherence and satisfaction, improved health outcomes, and fewer lawsuits.[2] Patient satisfaction concerning dermoscopy use in dermatology has not been fully investigated. The aim of the study was to assess patient satisfaction with dermoscopy use in dermatologic consultations, and to investigate the determinants of patients’ satisfaction and trust towards dermatologists. We conducted a cross-sectional study of patients presenting with different skin diseases in dermatology consultations, over a 6-month period. Patient data, satisfaction, and trust were investigated using a five-section questionnaire through face-to-face interviews. This study was approved by the Ethics Committee of the Mohammed VI University of Health and Sciences of Casablanca in March 2021, approval number: CE/UM6SS/61/21. Demographic and clinical characteristics of the participants were collected, and prior knowledge of dermoscopy was investigated in the third section of the questionnaire. The responses to questions related to patients’ satisfaction and trust were assessed based on a 5-point Likert scale (“strongly agree,” “agree,” “neutral,” “disagree,” and “strongly disagree”). Statistical analysis was performed using IBM SPSS Statistics version 25 software. Descriptive statistics were expressed as means and percentages. Correlations between dermoscopy use and overall satisfaction and trust were examined using the Chi-square test. The results were considered statistically significant if the P value was < 0.05. A total of 121 patients were included in the study. The mean age was 37.8 ± 15.5 years, and the majority were females (73%). Approximately of these patients 55 (45.5%) who had a history of dermatological disorders and patients with a high level of education tend to change their doctor when they don’t use medical tools like dermoscopy (P = 0.013, P = 0.006, respectively). Dermoscope was recognized by 47% of patients, and patients with a history of dermatological disorders had better knowledge of dermoscopy (P = 0.018). A significant proportion of patients (52%) mentioned that only one doctor used dermoscopy. Of the included patients, 97.5% trusted their doctor when he or she used dermoscopy [Table 1].Table 1: Epidemiological characteristics of the participants and the determinants of patients’ satisfaction and trust towards dermatologistsOn the other hand, 95% of patients expressed satisfaction with the use of dermoscopy, particularly when their dermatologist showed and explained the dermoscopic images to them. When showing the patients pictures of different dermoscopy devices, 57% of them were able to recognize the exact device the doctor used during their consultation. Dermoscopy increased patients’ trust from 35% (without dermoscopy use) to 60% after using it. In addition, showing them their own dermoscopic photos increased their trust to 72%, especially for patients with a high level of education (P = 0.004). Because patient experience influences clinical health outcomes, there is a rising interest in patient satisfaction with healthcare services and in the methods used during consultations to assess and enhance it. However, few studies have investigated overall patient satisfaction in outpatient dermatologic consultations. The most important factors determining patient satisfaction involved dermatologists’ specific skills and the medical tools used to confirm and complete the clinical examination, in addition to the quality of physician-patient communication.[3] The study of De Salins et al.[4] was the only previous study in which dermoscopy use was among the factors influencing patient overall satisfaction in addition to quality of life, physician’s concern, interest in the medical problem, attention given to symptoms, performance of a full-body skin examination, and performance of a skin biopsy. In a comparative study of patients’ confidence in the diagnostic methods, handheld dermoscopy was underestimated by patients in comparison with digital dermoscopy, and teledermoscopy, but was better than naked-eye inspection.[5] Besides, given that patient experience is not always based on physicians’ performance and technical skills, it can be based on affinity and empathy. Providing explanations while showing the patients their dermoscopic photos increases their trust and satisfaction, as we have found in this study where patients were impressed by the dermoscopy pictures where they can see structures not seen by their naked eye. This is another argument that using dermoscopy and taking time to explain its findings and its implications for treatments are surely important determinants of patients loyalty to healthcare providers in dermatology departments. The major limitation is absence of a comparative assessment between dermoscopy and other medical tools. Also, other determinants related to the doctor’s communication skills that could influence patient trust and satisfaction were not studied. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. Use of artificial intelligence (AI) AI QuillBot AI was used to correct the grammatical errors.