{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T03:17:12Z","timestamp":1784690232403,"version":"3.55.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lentigo maligna (LM) can be treated surgically, topically using imiquimod, or simply observed. The risk of progression to melanoma is considered low. There is clinical equipoise on management in older or frail adults, with no decision aids available for managing LM in this group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To co-design a patient decision aid (PDA) for the management of LM in older or frail adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The PDA was targeted at patients at least 85 years old, or those aged 75\u201384 years with a Rockwood Clinical Frailty Score of at least 4. Semi-structured interviews were conducted with patients and healthcare practitioners (HCPs) to co-design the tool. Thematic analysis was performed using NVivo 14. The prototype was tested via structured interviews with patients and HCPs, and amended in an iterative process until saturation was achieved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 13 patients and 18 HCPs were interviewed to co-design the prototype. Alpha-testing resulted in saturation after 20 iterations. The following key themes (and subthemes) were identified Theme 1: fear of cancer (definition of LM; risk of progression; prognosis); Theme 2: burden of treatment (risks, side effects and delays in treatment; likelihood of recurrence; frequency of follow-up; impact on quality of life); Theme 3: partnership and shared decision-making (empowering patients; involving family and carers; burden of responsibility); and Theme 4: information overload (less is more; accessibility).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is the first PDA for the management of LM in older and frail patients. This co-designed, patient-centred tool may empower patients to participate in decision-making by better understanding LM and the available management options.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/skinhd\/vzaf118","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T12:54:56Z","timestamp":1766235296000},"page":"265-272","source":"Crossref","is-referenced-by-count":2,"title":["Co-design of a decision aid for the management of lentigo maligna in older and frailer adults"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8847-7537","authenticated-orcid":false,"given":"Dimitrios","family":"Karponis","sequence":"first","affiliation":[{"name":"Norwich Medical School, University of East Anglia , Norwich ,","place":["UK"]},{"name":"Department of Dermatology, Norfolk and Norwich University Hospital , Norwich ,","place":["UK"]},{"name":"1st Department of Dermatology-Venereology, National and Kapodistrian 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Sygros Hospital , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Nikolaou","sequence":"additional","affiliation":[{"name":"1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe C","family":"Venables","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia , Norwich ,","place":["UK"]},{"name":"Department of Dermatology, Norfolk and Norwich University Hospital , Norwich ,","place":["UK"]},{"name":"National Disease Registration Service, Data and Analytics, NHS Digital , Leeds 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