{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:22:44Z","timestamp":1770895364117,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>To investigate patient experiences and satisfaction with imiquimod for cervical high\u2010grade squamous intraepithelial lesions and its side effects, possibly influencing the (dis)continuation of treatment. Secondary objectives include evaluating patient counseling and guidance before and during imiquimod treatment for cervical high\u2010grade squamous intraepithelial lesions by gynecologists and nurse practitioners to improve patient guidance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>Semi\u2010structured interviews were conducted with patients treated with imiquimod for cervical high\u2010grade squamous intraepithelial lesions and with healthcare professionals from hospitals in the Netherlands. Interviews were transcribed and transcripts were analyzed using thematic analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 15 patients, 11 of whom finished imiquimod treatment and four who discontinued imiquimod treatment, and six healthcare professionals were interviewed. Three main themes were identified: counseling and side effects, use of imiquimod, and contact moments during treatment. Many patients believed that sharing patient experiences would help in making treatment decisions. Patients discontinued treatment early due to side effects and the mode of application. Detailed information on application methods and side effect severity during counseling is desirable. Healthcare professionals agreed on the factors that need to be addressed during counseling but held different opinions on imiquimod's side effect severity and application methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adequate patient counseling on imiquimod treatment, including the possible application methods and potential side effects, along with optimal guidance during treatment, contributes to a better patient experience and reduces the likelihood of early discontinuation of treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.70004","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T16:40:16Z","timestamp":1752079216000},"page":"1712-1719","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Improving imiquimod use in cervical high\u2010grade squamous intraepithelial lesions: A qualitative study"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2886-3436","authenticated-orcid":false,"given":"Caroline L. P.","family":"Muntinga","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics Catharina Ziekenhuis Eindhoven  Eindhoven The Netherlands"},{"name":"GROW\u2014School for Oncology and Reproduction Maastricht University  Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena C. J.","family":"Schellekens","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Catharina Ziekenhuis Eindhoven  Eindhoven The Netherlands"},{"name":"GROW\u2014School for Oncology and Reproduction Maastricht University  Maastricht The Netherlands"},{"name":"Department of Gynecology and Obstetrics Maastricht Universitair Medisch Centrum  Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte G. J.","family":"Penders","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Maastricht Universitair Medisch Centrum  Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9l\u00e8ne","family":"van Meir","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Tergooi Medisch Centrum  Hilversum The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gatske M.","family":"Nieuwenhuyzen\u2010De Boer","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Albert Schweitzer Ziekenhuis  Dordrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna J. M.","family":"van de Sande","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Erasmus MC Cancer Center University Medical Center  Rotterdam The Netherlands"},{"name":"Department of Gynecology and Obstetrics, Franciscus Gasthuis and Vlietland  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8899-7412","authenticated-orcid":false,"given":"Heleen J.","family":"van Beekhuizen","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Erasmus MC Cancer Center University Medical Center  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peggy J.","family":"de Vos Van Steenwijk","sequence":"additional","affiliation":[{"name":"GROW\u2014School for Oncology and Reproduction Maastricht University  Maastricht The Netherlands"},{"name":"Department of Gynecology and Obstetrics Maastricht Universitair Medisch Centrum  Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruud L. M.","family":"Bekkers","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Catharina Ziekenhuis Eindhoven  Eindhoven The Netherlands"},{"name":"GROW\u2014School for Oncology and Reproduction Maastricht University  Maastricht The Netherlands"},{"name":"Department of Gynecologic Oncology, Radboudumc  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edith M. G.","family":"van Esch","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Catharina Ziekenhuis Eindhoven  Eindhoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(97)00177-0"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2004.12.008"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199802123380703"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003665"},{"issue":"11","key":"e_1_2_11_6_1","article-title":"Obstetric outcomes after conservative treatment for cervical intraepithelial lesions and early invasive disease","volume":"2017","author":"Kyrgiou M","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_7_1","unstructured":"CIN.AIS en VAIN.2021."},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.07.038"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k499"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11051432"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31825bc6e8"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14953"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/CJI.0000000000000414"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-2-12"},{"key":"e_1_2_11_15_1","first-page":"207","article-title":"De Female Sexual Function Index (FSFI) en de Female Sexual Distress Scale (FSDS): Psychometrische eigenschappen in een Nederlandse populatie","volume":"33","author":"Kuile M","year":"2009","journal-title":"Tijdschr Sexuol"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9903-x"},{"key":"e_1_2_11_17_1","unstructured":"ATLAS.ti Mac. 23.2.1 ed: ATLAS.ti Scientific Software Development GmbH; 2023. p. 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