Analysis of reasons for loss to follow up in a prospective study in Chandigarh, India and impact from telecom changes

Abstract Objective Mobile phones are used in research studies, to enroll and follow-up participants, collect data, and implement mHealth initiatives. We conducted a longitudinal study in a birth cohort, where infants were required to make four scheduled visits by 12 months of age. Families of those failing to attend scheduled follow-up visits, were contacted telephonically to ascertain the reasons, which were categorized as: not interested to continue participating, migrated, phone disconnected due to telecom change, or other reason. Results A total of 413 mother-infant dyads were enrolled. The overall attrition was 56%, with majority occurring at the first follow-up visit. This temporally coincided with a telecom service provider announcing strong incentives to switch providers. Attrition monotonically decreased at subsequent visits. The reasons were: moved away (13%), no longer interested (8%), phone disconnected (7%), and multiple other reasons (28%), the majority of whom had unreachable phones. Those who remained in the study and those lost to follow-up were similar on most demographic variables. Among common reasons for attrition in cohort studies, we experienced a new dimension introduced by telecom changes. These findings underscore the need to consider unexpected reasons for attrition in longitudinal studies, and design more robust methods to follow-up participants.

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Patient Loss to Follow-up After Upper Extremity Surgery: A Review of 2563 Cases

Hand ◽

10.1177/1558944718787277 ◽

2018 ◽

Vol 14 (6) ◽

pp. 836-840

Author(s):

Joseph A. Rosenbaum ◽

Yoni M. Blau ◽

Hannah K. Fox ◽

X. Shawn Liu ◽

Alex C. DiBartola ◽

...

Keyword(s):

Upper Extremity ◽

Postoperative Care ◽

Private Insurance ◽

Demographic Variables ◽

Loss To Follow Up ◽

Long Term Follow Up ◽

Lost To Follow Up ◽

Surgery Center

Background: Postoperative care is essential to optimizing patient outcome. We sought to determine the incidence and associated demographic and surgical factors of postoperative patient loss to follow-up following hand and upper extremity surgery. Methods: In all, 2834 surgical cases (2467 patients) were retrospectively reviewed. All surgical cases from July 2014 to June 2015 at a single practice with five surgeons were assessed. Charts were reviewed for compliance with postoperative follow-up. Variables were described with proportions and compared using logistic regression analysis. Results: In total, 2563 cases (2388 patients) met the inclusion criteria. Overall loss to follow-up rate was 26%. Patients lost to follow-up based on insurance type were 13% for worker’s compensation, 22% for private insurance, 21% for Medicare, 38% for Medicaid, and 44% for self-pay. Patients with expected short-term follow-up were lost at a 23% rate. Expected mid- and long-term follow-up patients were lost at 34% and 20% rates, respectively. Patients below 30 years old were lost to follow-up at a 42% rate compared to patients 30 to 64 years old (26%) and greater than or equal to 65 years (13%). Males had a higher rate of loss to follow-up, 32%, compared with females (22%). Patients living greater than 50 miles from our surgery center were lost to follow-up at a rate of 31%, compared with those who lived less than 50 miles (25%). Conclusions: We have identified demographic variables associated with patients being lost to follow-up after hand and upper extremity surgery. With this knowledge, we hope to develop methods of either improving in-office follow-up rates or discover new avenues to deliver postoperative care.

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

AIDS Research and Therapy ◽

10.1186/s12981-019-0241-3 ◽

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.

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

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.11569 ◽

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]

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

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363510x487795 ◽

2010 ◽

Vol 92 (3) ◽

pp. 98-101 ◽

Cited By ~ 5

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.

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Does Forehand Racquet Handgrip influence Incidence and Type of Wrist Injury in Tennis? A Preliminary Study in Indian Tennis

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1265 ◽

2018 ◽

Vol 52 (1) ◽

pp. 1-4

Author(s):

Sharad Prabhakar ◽

Mandeep S Dhillon ◽

Himmat Dhillon ◽

Sidak Dhillon ◽

Dharam S Meena

Keyword(s):

Daily Practice ◽

Statistical Correlation ◽

Anatomical Site ◽

Wrist Injuries ◽

Wrist Injury ◽

Tennis Players ◽

Preliminary Study ◽

A Prospective Study ◽

Lost To Follow Up

ABSTRACT Introduction Tennis is one of the major global sports, with over 75 million players participating in the game in more than 200 countries affiliated with the International Tennis Federation. The upper extremity is particularly susceptible to injury in tennis because of the use of the racquet, which acts as a lever, and due to the effect of repetitive stroke play on the dominant limb. Materials and methods Between July 2009 and October 2010, in a prospective study involving players at a local tennis academy, 219 tennis players were evaluated for wrist injury. A specialized injury proforma was filled up for these players and parameters, such as injury type, mechanism of injury, forehand racquet grip (eastern, western and semiwestern), missed time from game, and treatment (medical or surgical) were recorded. The players were grouped into low-intensity players (those with average daily practice hours < 2.5) and high-intensity players (with ≥ 2.5 daily average practice hours). Statistical analysis was performed to assess the association of different wrist injuries with type of forehand handgrip. Results Out of 219 players, 14 players were lost to follow-up. Out of the remaining 205 players, a total of 157 (76%) players were aware of the type of handgrip they were using, while 18 (9%) players did not have any knowledge of their handgrip. The remaining 30 (15%) players were found to be confused as far as handgrip was concerned. Out of 157 players who had knowledge regarding handgrip, 102 players were using the semiwestern grip, 44 were using the western grip, and the remaining 11 were using the eastern type of handgrip. There were seven injuries sustained in the wrist and hand. Due to the relatively small number of wrist injury cases, no statistical correlation could be derived between handgrip use and specific injuries in the upper limb. Conclusion In tennis players with wrist injuries, different grips of the racquet are not related to the anatomical site of the lesion. Previous studies have correlated the type of handgrip with the pattern of wrist injuries. Though we have 219 players in our study, the players who sustained wrist injuries were less (7). Thus, we were unable to find any correlation between type of handgrip and pattern of wrist injuries. Further studies are required so as to understand the biomechanics of tennis injuries. How to cite this article Prabhakar S, Dhillon MS, Meena DS, Dhillon H, Dhillon S. Does Forehand Racquet Handgrip influence Incidence and Type of Wrist Injury in Tennis? A Preliminary Study in Indian Tennis. J Postgrad Med Edu Res 2018;52(1):1-4.

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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

African Journal of Urology ◽

10.1186/s12301-021-00212-3 ◽

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%.

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

Hormone Research in Paediatrics ◽

10.1159/000475595 ◽

2017 ◽

Vol 87 (6) ◽

pp. 377-384 ◽

Cited By ~ 6

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.

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

Foot & Ankle Specialist ◽

10.1177/1938640018776065 ◽

2018 ◽

Vol 12 (2) ◽

pp. 153-158 ◽

Cited By ~ 4

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

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Mortality and Morbidity in Infants Less Than 1,001 Grams Birth Weight

PEDIATRICS ◽

10.1542/peds.69.1.21 ◽

1982 ◽

Vol 69 (1) ◽

pp. 21-26

Author(s):

John M. Driscoll ◽

Yvonne T. Driscoll ◽

Mary E. Steir ◽

Raymond I. Stark ◽

Barbara C. Dangman ◽

...

Keyword(s):

Neonatal Mortality ◽

Perinatal Asphyxia ◽

Birth Asphyxia ◽

Retrolental Fibroplasia ◽

Mortality And Morbidity ◽

Intellectual Deficit ◽

Static Encephalopathy ◽

A Prospective Study ◽

Lost To Follow Up

A prospective study of 54 infants with birth weights of 1,000 gm or less was conducted over a period of two years. Of the 26 infants who survived, 24 weighed between 750 and 1,000 gm; two infants died after discharge and one was lost to follow-up, leaving 23 in whom serial observations were made over 18 months to 3 years of age. The incidence of neurologic deficit in these infants was 17% and of intellectual deficit, 13%. Of the four who were abnormal neurologically, two had spastic quadriparesis, one static encephalopathy, and one hydrocephalus secondary to intraventricular hemorrhage. The three with intellectual deficit had a developmental quotient <85. Of the perinatal factors examined, only birth asphyxia correlated significantly with both neonatal mortality and subsequent morbidity. Six (26%) of the surviving infants had mild, nonblinding retrolental fibroplasia; only one of them had a significant refractive error that required corrective lenses for vision. Sepsis was a significant contributor to neonatal mortality in ten of 28 infants who died, but was detected in only one survivor. Although the prognosis for the infant weighing 1,000 gm or less at delivery has improved significantly, there is promise for still further improvement by reducing perinatal asphyxia.

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WHO IS LOST TO FOLLOW-UP?

PEDIATRICS ◽

10.1542/peds.84.5.a38 ◽

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.

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