Photodynamic therapy for actinic keratoses: Survey of patient perceptions of treatment satisfaction and outcomes

Background: While there are many available treatments for actinic keratoses (AKs), patient-preferred treatment options remain undefined. Objective: To quantify patient perceptions and preferences in the management of AKs, including comparison of photodynamic therapy (PDT) with other therapies. Methods: A self-administered questionnaire was mailed to 45 patients who had received PDT for AKs in 2005-2006 in the Henry Ford Health System. A series of indicators for each treatment were surveyed, including: recovery time, cosmetic appearance, patient cost, effectiveness, patient satisfaction, treatment option preference, and perceived burden of treatment. Results: A total of 39 of the 45 patients participated (86.7%). A patient's reported recovery time was significantly more likely to be 1 week or less for PDT when compared with cryotherapy (p50.02) and surgical excision ( p50.02). Borderline significance was found for the improved cosmetic outcome in PDT vs. surgical excision (p50.058) and for patient satisfaction with PDT compared with 5-fluorouracil ( p50.058). Patients significantly preferred PDT to 5-fluorouracil (pv0.001) or imiquimod (p50.031). Conclusion: While the effectiveness of lesion clearance with PDT for AKs has been well proven in the literature, this is the first study to evaluate patient perception of the effectiveness, side-effect profile and benefits of PDT relative to several standard treatment approaches for AKs. PDT was found to have equivalent or improved recovery times, cosmetic outcomes, patient satisfaction and preference as a treatment for AKs by patients compared with other options.