scholarly journals Strategy to track double-J stents placed during COVID-19 using smartphone-based stent tracker application to prevent forgotten double-J stent in a high-volume centre: a smart solution

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Abhirudra Mulay ◽  
Rohit Kapoor ◽  
Sonu Sharma ◽  
Shashikant Asabe ◽  
Hareesh Belagali ◽  
...  
Keyword(s):  
Data Storage ◽  
High Volume ◽  
Daily Lives ◽  
Loss To Follow Up ◽  
Regional Language ◽  
Contagious Nature ◽  
Double J Stent ◽  
Paediatric Age ◽  
Lost To Follow Up

Abstract Background Forgotten or retained (double-J) DJ stents may lead to several complications. Management of retained DJ stents poses a challenge for urologists not just surgically but also medicolegally and adds to the economic burden of the patient. Difficulty in follow-up for patients due to the contagious nature of COVID-19 and several restrictions posed in the form of lockdown. Smartphones today have become an integral part of our daily lives providing a convenient and reliable platform for data storage and access. Methods All patients requiring placement of DJ stents and agreeing to enrol in the study were registered on the application over the physicians smartphone. SMSs regarding dates for removal of stent and follow-up with the literature regarding stent care were sent to the patients in their regional language. Results A total of 100 patients were stented during this period of 3 months. Mean age was 42.61 years with three patients of paediatric age group. Mean duration of stent was 6 weeks. All patients received periodic messages (average 3) regarding follow-up and date for stent removal. 3%(n = 3) patients were delayed for follow-up; 2% (n = 2) patients lost to follow-up, compared to a 9% to 10% loss to follow-up in patients followed up only on paper discharges in our department previously. Conclusion It significantly reduced the number of physical visits of the patient to the hospital and provided a more streamlined tracking of the indwelling stents for the user; patient compliance was found to be almost 98%; being cloud based (android/iOS), it was easily accessible to the user; and with the option of sharing the account details, the patient record could be accessed by several residents from their individual devices, which significantly reduced loss to follow-up rates from 9 to 2%.

scholarly journals Predictors of loss to follow-up in art experienced patients in Nigeria: a 13 year review (2004–2017)

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Ahmad Aliyu ◽  
Babatunde Adelekan ◽  
Nifarta Andrew ◽  
Eunice Ekong ◽  
Stephen Dapiap ◽  
...  
Keyword(s):  
Patient Adherence ◽  
Cross Sectional Study ◽  
Emergency Plan ◽  
Cross Sectional ◽  
Loss To Follow Up ◽  
Viral Loads ◽  
Review Period ◽  
Lost To Follow Up ◽  
Differentiated Care

Abstract Background Expanded access to antiretroviral therapy (ART) leads to improved HIV/AIDS treatment outcomes in Nigeria, however, increasing rates of loss to follow-up among those on ART is threatening optimal standard achievement. Therefore, this retrospective cross-sectional study is aimed at identifying correlates and predictors of loss to follow-up in patients commencing ART in a large HIV program in Nigeria. Methods Records of all patients from 432 US CDC Presidents Emergency Plan for AIDS Relief (PEPFAR) supported facilities across 10 States and FCT who started ART from 2004 to 2017 were used for this study. Bivariate and multivariate analysis of the demographic and clinical parameters of all patients was conducted using STATA version 14 to determine correlates and predictors of loss to follow-up. Results Within the review period, 245,257 patients were ever enrolled on anti-retroviral therapy. 150,191 (61.2%) remained on treatment, 10,960 (4.5%) were transferred out to other facilities, 6926 (2.8%) died, 2139 (0.9%) self-terminated treatment and 75,041 (30.6%) had a loss to follow-up event captured. Males (OR: 1.16), Non-pregnant female (OR: 4.55), Patients on ≥ 3-monthly ARV refills (OR: 1.32), Patients with un-suppressed viral loads on ART (OR: 4.52), patients on adult 2nd line regimen (OR: 1.23) or pediatric on 1st line regimen (OR: 1.70) were significantly more likely to be lost to follow-up. Conclusion Despite increasing access to anti-retroviral therapy, loss to follow-up is still a challenge in the HIV program in Nigeria. Differentiated care approaches that will focus on males, non-pregnant females and paediatrics is encouraged. Reducing months of Anti-retroviral drug refill to less than 3 months is advocated for increased patient adherence.

Prospective cohort study of Kaposi sarcoma treated under real-world conditions in Malawi.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11569-11569
Author(s):  
Edwards Kasonkanji ◽  
Yolanda Gondwe ◽  
Morgan Dewey ◽  
Joe Gumulira ◽  
Matthew Painschab ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kaposi Sarcoma ◽  
Median Number ◽  
Sub Saharan Africa ◽  
Worst Case ◽  
Loss To Follow Up ◽  
Presenting Symptoms ◽  
Grade 3 ◽  
Lost To Follow Up

11569 Background: Kaposi sarcoma (KS) is the leading cancer in Malawi (34% of cancers). Outside of clinical trials, prospective KS studies from sub-Saharan Africa (SSA) are few and limited by loss to follow up. We conducted a prospective KS cohort study of standard of care bleomycin/vincristine (BV) at Lighthouse HIV clinic, in Lilongwe, Malawi. Methods: We enrolled pathologically confirmed, newly diagnosed, HIV+ KS patients from Feb 2017 to Jun 2019. We collected clinical and treatment characteristics, toxicity, and outcomes of KS with follow-up censored Jun 2020. Patients were treated with bleomycin (25 mg/m2) and vincristine (0.4 mg/m2) every 14 days for a planned maximum of 16 cycles. STATA v13.0 was used to calculate descriptive statistics and Kaplan Meier survival analysis. Toxicity was graded using NCI CTCAE v5.0. Results: We enrolled 138 participants, median age 36 (IQR 32-44) and 110 (80%) male. By ACTG staging, 107 (78%) were T1 (tumour severity), 46 (33%) were S1 (illness severity) and 46 (33%) had Karnofsky performance status ≤70. Presenting symptoms included edema in 69 (53%), visceral disease in 9 (7%), and oral involvement in 43 (33%). Prior to KS diagnosis, 70 (51%) participants were aware of being HIV+ for median 17 months (IQR 6-60) and had been on ART for median 16 months (IQR 6-60). Median CD4 count was 197 (IQR 99-339), median HIV-viral load was 2.6 log copies/mL (IQR 1.6 – 4.8) and 57% were HIV-suppressed ( < 1000 HIV copies/ml). The median number of cycles was 16 (IQR 7-16). 62 (45%) participants missed at least one dose due to stock out. Amongst patients with missed doses, the median number was 3 (IQR 2-4) for bleomycin and 2 (IQR 1-3) for vincristine. 14 (10%) participants experienced at least one reduced dose due to toxicity. 5 (4%) participants suffered grade ≥3 anaemia, 13 (9%) grade ≥3 neutropenia, and one participant had grade 4 bleomycin-induced dermatitis. There was no reported grade ≥3 bleomycin lung toxicity or vincristine-induced neuropathy. Of 115 evaluable participants, responses at the end of therapy were: complete response in 52 (45%), partial response in 27 (23%) stable disease in 5 (4%), and progressive disease in 31 (28%). Median duration of follow-up was 20 months. At censoring, 69 (50%) were alive, 36 (26%) dead, and 33 (24%) lost to follow-up. Overall survival is shown Table as crude and worst-case scenario; worst-case assumes all participants lost to follow up died. Conclusions: Here, we present one of the most complete characterizations of KS presentation and treatment from SSA. As in other studies from the region, the majority of patients presented with advanced disease, chemotherapy stock-outs and loss to follow up were common, and mortality was high. Studies are planned to understand the virologic characteristics, improve therapies, and better implement existing therapies.[Table: see text]

How to Find Patients Who are 'Lost to Follow-up'

2010 ◽  
Vol 92 (3) ◽  
pp. 98-101 ◽  
Author(s):  
LC Biant ◽  
VK Eswaramoorthy ◽  
RE Field
Keyword(s):  
Surgical Interventions ◽  
Loss To Follow Up ◽  
Medical Interventions ◽  
Follow Up Studies ◽  
Long Term Follow Up ◽  
Lost To Follow Up

Long-term surveillance of patients is necessary to ascertain the outcome of medical interventions. The rate of 'loss to follow-up' is the largest controllable variable in long-term follow-up studies. Such surveillance programmes are of particular importance to surgical interventions as differences between techniques or implants may take years to become apparent.

scholarly journals Predictors of Loss to Follow-Up among Children with Type 2 Diabetes

2017 ◽  
Vol 87 (6) ◽  
pp. 377-384 ◽  
Author(s):  
Ashley Shoemaker ◽  
Peiyao Cheng ◽  
Robin L. Gal ◽  
Craig Kollman ◽  
William V. Tamborlane ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Parent Education ◽  
A Priori ◽  
Loss To Follow Up ◽  
Logistic Regression Models ◽  
Pediatric Diabetes ◽  
Diabetes Center ◽  
Lost To Follow Up

Background/Aims: Youth with type 2 diabetes (T2D) have poor compliance with medical care. This study aimed to determine which demographic and clinical factors differ between youth with T2D who receive care in a pediatric diabetes center versus youth lost to follow-up for >18 months. Methods: Data were analyzed from 496 subjects in the Pe­diatric Diabetes Consortium registry. Enrollment variables were selected a priori and analyzed with univariable and multivariable logistic regression models. Results: After a median of 1.3 years from enrollment, 55% of patients were lost to follow-up. The final model included age, race/ethnicity, parent education, and estimated distance to study site. The odds ratio (99% confidence interval) of loss to follow-up was 2.87 (1.34, 6.16) for those aged 15 to <18 years versus those aged 10 to <13 years and 6.57 (2.67, 16.15) for those aged ≥18 years versus those aged 10 to <13 years. Among patients living more than 50 miles from the clinic, the odds ra tio of loss to follow-up was 3.11 (1.14, 8.49) versus those living within 5 miles of the site. Conclusion: Older adolescents with T2D are more likely to be lost to follow-up, but other socioeconomic factors were not significant predictors of clinic follow-up.

A Feasibility Study Comparing Platelet-Rich Plasma Injection With Saline for the Treatment of Plantar Fasciitis Using a Prospective, Randomized Trial Design

2018 ◽  
Vol 12 (2) ◽  
pp. 153-158 ◽  
Author(s):  
Sarah Johnson-Lynn ◽  
Alan Cooney ◽  
Diarmaid Ferguson ◽  
Deborah Bunn ◽  
William Gray ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Resonance Imaging ◽  
Loss To Follow Up ◽  
Plasma Injection ◽  
Level Ii ◽  
Lost To Follow Up ◽  
And Control

Platelet-rich plasma (PRP) has been advocated for treatment of plantar fasciitis but there are few good-quality clinical trials to support its use. We conducted a feasibility study of PRP versus saline for treatment of plantar fasciitis. Patients with 6 months or more of magnetic resonance imaging–proven plantar fasciitis, who had failed conservative treatment were invited to participate in the study. Patients were block randomized to either PRP or an equivalent volume of saline. The techniques used for injection and rehabilitation were standardized for both groups. The patient and assessor were blinded. Visual analogue scale (VAS) for pain and painDETECT score were recorded preoperatively and at 6 months follow-up. From 35 patients approached, 28 (19 female, mean age 50 years) were recruited, with 14 randomized to each arm. At 6 months, 8 patients (28.6%) were lost to follow-up. There was a significant change in VAS score from baseline to follow-up in both intervention (mean change 37.2, P = .008) and control (mean change 42.2, P = .003) groups. There was no correlation between preoperative painDETECT score and change in VAS. Recruitment and loss to follow-up rates were relatively high. Both treatments resulted in a similar, significant, improvement in symptoms. Levels of Evidence: Level II

WHO IS LOST TO FOLLOW-UP?

PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. A38-A38
Author(s):  
Student
Keyword(s):  
High Risk ◽  
Major Effect ◽  
Dropout Rates ◽  
Time Interval ◽  
Environmental Characteristics ◽  
Developmental Status ◽  
Loss To Follow Up ◽  
High Risk Infants ◽  
Lost To Follow Up

The belief that impaired infants are more likely to continue in follow-up is. . .not supported. The infant's developmental status significantly influenced loss to follow-up only between the 18-to 36-month time interval. Here, more babies in the dubious (vs abnormal) category withdrew. In general our findings suggest that environmental characteristics exert the major effect on dropout rates in high risk infants and their controls.

Dedicated Tracking of Patients with Retrievable Inferior Vena Cava Filters Improves Retrieval Rates

2012 ◽  
Vol 78 (8) ◽  
pp. 870-874 ◽  
Author(s):  
Donald J. Lucas ◽  
James R. Dunne ◽  
Carlos J. Rodriguez ◽  
Kathleen M. Curry ◽  
Eric Elster ◽  
...  
Keyword(s):  
Vena Cava ◽  
Control Group ◽  
Trauma Patients ◽  
Loss To Follow Up ◽  
Filter Retrieval ◽  
Ivc Filters ◽  
Vena Cava Filters ◽  
Baseline Characteristics ◽  
Lost To Follow Up

Retrievable IVC filters (R-IVCF) are associated with multiple complications, including filter migration and deep venous thrombosis. Unfortunately, most series of R-IVCF show low retrieval rates, often due to loss to follow-up. This study demonstrates that actively tracking R-IVCF improves retrieval. Trauma patients at one institution with R-IVCF placed between January 2007 and January 2011 were tracked in a registry with a goal of retrieval. These were compared to a control group who had R-IVCF placed previously (December 2005 to December 2006). Outcome measures include filter retrieval, retrieval attempts, loss to follow-up, and time to filter retrieval. We compared 93 tracked patients with R-IVCF with 20 controls. The baseline characteristics of the groups were similar. Tracked patients had significantly higher rates of filter retrieval (60% vs 30%, P = 0.02) and filter retrieval attempts (70% vs 30%, P = 0.002) and were significantly less likely to be lost to follow-up (5% vs 65%, P < 0.0001). Time to retrieval attempt was 84 days in the registry versus 210 days in the control group, which trended towards significance ( P = 0.23). Tracking patients with R-IVCF leads to improved retrieval rates, more retrieval attempts, and decreased loss to follow up. Institutions should consider tracking R-IVCF to maximize retrieval rates.

Retaining HIV-positive patients in HIV care: a personalised approach for those at risk of loss to follow-up at an inner city sexual health service

Sexual Health ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 91
Author(s):  
Loretta Healey ◽  
Catherine C. O'Connor
Keyword(s):  
Health Service ◽  
Sexual Health ◽  
Text Messages ◽  
Hiv Care ◽  
Hiv Positive ◽  
Hiv Patients ◽  
Loss To Follow Up ◽  
Sexual Health Service ◽  
Lost To Follow Up

In 2013 a personalised approach to follow-up of HIV patients who had withdrawn from HIV care was taken at RPA Sexual Health, a Sydney metropolitan sexual health service. HIV patients were telephoned, sent text messages, emailed and sent letters multiple times where applicable. With this intervention 20 of 23 people who had withdrawn from HIV care re-engaged. Since that time, active follow-up of all people diagnosed with HIV has resulted in only 2% of HIV patients at RPA Sexual Health being lost to follow-up.

scholarly journals An empirical analysis of dealing with patients who are lost to follow-up when developing prognostic models using a cohort design

2020 ◽  
Author(s):  
Jenna M Reps ◽  
Peter Rijnbeek ◽  
Alana Cuthbert ◽  
Patrick B Ryan ◽  
Nicole Pratt ◽  
...  
Keyword(s):  
At Risk ◽  
Real World ◽  
Synthetic Data ◽  
Real World Data ◽  
Test Set ◽  
Loss To Follow Up ◽  
World Data ◽  
Cohort Design ◽  
Lost To Follow Up

Abstract Background: Researchers developing prediction models are faced with numerous design choices that may impact model performance. One key decision is how to include patients who are lost to follow-up. In this paper we perform a large-scale empirical evaluation investigating the impact of this decision. In addition, we aim to provide guidelines for how to deal with loss to follow-up.Methods: We generate a partially synthetic dataset with complete follow-up and simulate loss to follow-up based either on random selection or on selection based on comorbidity. In addition to our synthetic data study we investigate 21 real-world data prediction problems. We compare four simple strategies for developing models when using a cohort design that encounters loss to follow-up. Three strategies employ a binary classifier with data that: i) include all patients (including those lost to follow-up), ii) exclude all patients lost to follow-up or iii) only exclude patients lost to follow-up who do not have the outcome before being lost to follow-up. The fourth strategy uses a survival model with data that include all patients. We empirically evaluate the discrimination and calibration performance.Results: The partially synthetic data study results show that excluding patients who are lost to follow-up can introduce bias when loss to follow-up is common and does not occur at random. However, when loss to follow-up was completely at random, the choice of addressing it had negligible impact on model discrimination performance. Our empirical real-world data results showed that the four design choices investigated to deal with loss to follow-up resulted in comparable performance when the time-at-risk was 1-year but demonstrated differential bias when we looked into 3-year time-at-risk. Removing patients who are lost to follow-up before experiencing the outcome but keeping patients who are lost to follow-up after the outcome can bias a model and should be avoided.Conclusion: Based on this study we therefore recommend i) developing models using data that includes patients that are lost to follow-up and ii) evaluate the discrimination and calibration of models twice: on a test set including patients lost to follow-up and a test set excluding patients lost to follow-up.

scholarly journals The cost and effect of expanding a Patient Tracer programme to identify and return patients loss to follow up at a large HIV Clinic in Trinidad

2020 ◽  
Author(s):  
R. Jeffrey Edwards ◽  
Nyla Lyons ◽  
Wendy Samaroo-Francis ◽  
Leon-Omari Lavia ◽  
Isshad John ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Hiv Care ◽  
Loss To Follow Up ◽  
Treatment Clinic ◽  
The Status ◽  
Clinic Medical ◽  
The Cost ◽  
Lost To Follow Up ◽  
Over Time

Abstract Background: Patients who default from HIV care are usually poorly adherent to antiretroviral treatment which results in suboptimal viral suppression. The study evaluated the effect and cost of expanding an intervention using two Patient Tracers to track and return to care patients lost to follow up at a large HIV Clinic in Trinidad.Methods: Two Social Workers were trained as Patient Tracers and hired initially for 6 months (April –September 2017), then extended to 15 months (April 2017 – June 2018) to call patients who were lost to follow up for 30 days or more during the period July 2016 – May 2018 at the HIV Clinic Medical Research Foundation of Trinidad and Tobago. Both the outcomes of the intervention, and costs were assessed over time. Results: Over the 15 month period, of the of 2,473 patients who missed their scheduled visits for one month or more, 261 (10.6%) patients were no longer in active care - 89 patients dead, 65 migrated, 55 hospitalized, 33 transferred to another treatment clinic and 19 incarcerated. Of the remaining 2,212 patients eligible for tracing, 1,794 (81.1%) patients were returned to care at an average cost of $38.09 USD per patient returned to care as compared to 589 of 866 (68%) patients returned to care over the 6 month period (p < 0.001) at an estimated cost of $47.72 USD per patient returned to care (p<0.001). Of the 1,794 patients returned to care, 1,686 (94%) were re-initiated/started on anti-retroviral therapy and 72.7% of these were virally suppressed (viral load <1,000 copies/ml) as of December 2018.Conclusions: Patient Tracing is a feasible and effective intervention to identify and resolve the status of patients who are loss to follow up to bring these patients back into care with the aim of achieving viral suppression on antiretroviral therapy. Over time the effect of costs of patients returned to care demonstrated greater yields making patient tracing a sustainable intervention for programmes to identify and return patients to care.

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