Why are patients lost to follow-up in a gynecologic oncology clinic?

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17571-e17571 ◽  
Author(s):  
V. C. Garcia ◽  
A. M. Manalo ◽  
J. B. Toral ◽  
M. L. Siasu
Keyword(s):  
Educational Attainment ◽  
Marital Status ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Cancer Type ◽  
Monthly Income ◽  
Family Commitment ◽  
Number Of Patients ◽  
Lost To Follow Up

e17571 Background: The aim of this study is to investigate why patients are lost to follow-up in a gynecologic oncology clinic. Methods: Patients who had been lost to follow up previously, and eventually followed up between April and August 2007 were given a consent form and questionnaire to answer. An approximately equal number of patients who were not lost to follow-up were given the same questionnaire as controls. The first part of the questionnaire included the age, marital status, location, diagnosis/type of gynecologic cancer, type of intervention, educational attainment, occupation and monthly income. The second part asked directly the reason why they were lost to follow-up. Data were recorded in a computerized database via Microsoft Excel. Descriptive statistics were presented in mean, median, standard deviation, minimum, maximum and frequencies. Differences between patients who failed to follow-up (LF) and their controls (NLF) with respect to demographics, disease and treatment characteristics were assessed by an x2 test or independent t test, depending on the variable. SPSS version 15 was used to perform all analyses. A p < 0.05 was considered significant. Results: There were 50 patients who were not lost and 52 patients who were lost to follow-up. The demographic characteristics between these two groups; i.e., age, marital status, location, diagnosis/type of gynecologic cancer, type of intervention, educational attainment, occupation, and monthly income of patients were all not statistically significant. The most common reason why patients were lost to follow-up was they had no money. Other reasons included: symptoms became better or problems resolved, the follow up was at an inconvenient time and I had family commitment. Conclusions: Patients expressed that the main reason for not following-up was the lack of funds. The majority in these respondents lived below the minimum salary wages. No significant financial relationships to disclose.

scholarly journals Results of early versus standard silicone stent removal following external dacryocystorhinostomy under local anesthesia

2020 ◽  
Vol 17 (3) ◽  
pp. 263-272
Author(s):  
Ben Limbu ◽  
Benjamin Sim ◽  
Mohan K. Shrestha ◽  
Geoffrey Tabin ◽  
Rohit Saiju
Keyword(s):  
Statistical Difference ◽  
Financial Burden ◽  
Controlled Trial ◽  
Silicone Tube ◽  
Number Of Patients ◽  
Tube Removal ◽  
Silicone Stent ◽  
External Dacryocystorhinostomy ◽  
Lost To Follow Up

Introduction: Many patients in Nepal travel vast distances to have their surgeries in Kathmandu. They often remain close by until their follow-up visit for their silicone tube removal, which contributes to a large financial burden on them and their families. Hence, reducing the time for which silicone tubes remain in situ following external dacryocystorhinostomy (DCR) provides significant benefits to patients. Furthermore, this is the first comparative study which has successfully demonstrated the earliest timeframe for which silicone tubes can be removed following DCR in the medical literature. Methods: A randomized controlled trial consisting of 144 patients was designed to compare patient outcomes after early (2 weeks postoperatively) versus standard (6 weeks postoperatively) removal of silicone stents. The success of their procedures was determined when patients were assessed both symptomatically and anatomically at their 6-month follow-up. Results: The surgical success in both groups was high at 97.8% collectively in both groups and there were only a small number of patients who were lost to follow-up (5 patients) at 6 months. There was no statistical difference at removing silicone stents at 2 or 6 weeks postoperatively. Conclusion: These results were consistent with our pilot study, which showed no statistical difference in long-term success following silicone tube removal at 2 and 6 weeks.

scholarly journals Sexual Health as Part of Gynecologic Cancer Care: What Do Patients Want?

2018 ◽  
Vol 28 (9) ◽  
pp. 1737-1742 ◽  
Author(s):  
Casey M. Hay ◽  
Heidi S. Donovan ◽  
Erin G. Hartnett ◽  
Jeanne Carter ◽  
Mary C. Roberge ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Sexual Activity ◽  
Cancer Patients ◽  
Cancer Care ◽  
Gynecologic Cancer ◽  
Relationship Status ◽  
Cancer Type ◽  
Sexual Health Care

ObjectiveSexual health is important to quality of life; however, the sexual health of gynecologic cancer patients is infrequently and inadequately addressed. We sought to understand patient experiences and preferences for sexual health care to help inform strategies for improvement.Methods/MaterialsAn anonymous, cross-sectional survey of outpatient gynecologic cancer patients at a large academic medical center was performed as part of a larger study examining patient and caregiver needs. The survey explored patient-provider discussions about sexuality across 3 domains (experiences, preferences, barriers) and 4 phases of cancer care (diagnosis, treatment, treatment completion, follow-up). Age, relationship status, sexual activity, and cancer type were recorded.ResultsMean age was 63 years. Most patients had ovarian cancer (38%) or endometrial cancer (32%). Thirty-seven percent received treatment within the last month, 55% were in a relationship, and 35% were sexuality active. Thirty-four percent reported sexuality as somewhat or very important, whereas 27% felt that it was somewhat or very important to discuss. Importance of sexuality was associated with age, relationship status, and sexual activity but not cancer type. Fifty-seven percent reported never discussing sexuality. Age was associated with sexuality discussions, whereas relationship status, sexual activity, and cancer type were not. The most common barrier to discussion was patient discomfort. Follow-up was identified as the best time for discussion. Sexuality was most often discussed with a physician or advanced practice provider and usually brought up by the provider.ConclusionsDemographic predictors of importance of sexuality to the patient are age, relationship status, and sexual activity. Providers primarily use age as a proxy for importance of sexuality; however, relationship status and sexual activity may represent additional ways to screen for patients interested in discussing sexual health. Patient discomfort with discussing sexuality is the primary barrier to sexual health discussions, and awareness of this is key to developing effective approaches to providing sexual health care.

scholarly journals Lost to follow up and clinical outcomes of HIV adult patients on antiretroviral therapy in care and treatment centres in Tanga City, north-eastern Tanzania

2012 ◽  
Vol 14 (4) ◽  
Author(s):  
Williams H. Makunde ◽  
Filbert Francis ◽  
Bruno P. Mmbando ◽  
Mathias L. Kamugisha ◽  
Acleus M. Rutta ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Scaling Up ◽  
Regional Hospital ◽  
Crucial Aspect ◽  
Number Of Patients ◽  
North Eastern ◽  
Patient Documentation ◽  
Care And Treatment ◽  
Lost To Follow Up

Scaling up of Antiretroviral (ARV) drugs is crucial and should be a perpetual venture in developing countries in-order to increase the survival period of HIV/AIDS individuals. In Tanzania, information on the rate of patients considered as lost to follow up during treatment with ARVs is scarce. The objective of this study was to determine the rate of lost to follow up and treatment outcome among patients attending two care and treatment clinics (CTCs) in Tanga City in north-eastern Tanzania. A descriptive observational study was carried out on cohorts from Tanga AIDS Working Group and Bombo Regional Hospital. The total number of patients identified as “lost to follow up” were 89 of which 14 (15.7%) died. Among those who died, 3 (21.4%) died between the second week and 3 months after ARV initiation. Of those still alive (84.3%; 75/89), 25% (19/75) were still on ARVs, whereas 47 (62.7%) self transferred to other CTCs. Proper patient documentation with actual residence address is a crucial aspect for adherence. Similarly, frequent prompt tracing of patient should be part of any drug interventional programme linking   facility and communities.

Leap forward in the treatment of Pythium insidiosum keratitis

2018 ◽  
Vol 102 (12) ◽  
pp. 1629-1633 ◽  
Author(s):  
Bhupesh Bagga ◽  
Savitri Sharma ◽  
Sai Jeevan Madhuri Guda ◽  
Ritu Nagpal ◽  
Joveeta Joseph ◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
Disc Diffusion ◽  
Pythium Insidiosum ◽  
Exact Test ◽  
Number Of Patients ◽  
Lost To Follow Up ◽  
Diffusion Assay ◽  
Culture Positive

BackgroundPythium insidiosum is a parafungus that causes keratitis resembling fungal keratitis. This study compares outcome in a large cohort of patients with P insidiosum keratitis treated with antifungal drugs, to a pilot group treated with antibacterial antibiotics.MethodsBetween January 2014 and December 2016, 114 patients with culture positive P insidiosum keratitis were included in the study. A subset of culture isolates was tested in vitro for response to nine antibacterial antibiotics by disc diffusion and E test. Patients were treated with topical natamycin in 2014, 2015 and up until mid 2016. Thereafter, the patients received a combination of topical linezolid and topical and oral azithromycin. Therapeutic penetrating keratoplasty (TPK) was done for patients not responding to medical therapy.ResultsIn vitro disc diffusion assay showed linezolid to be most effective. The rate of TPK was significantly higher in 2015 compared with 2016 (43/45, 95.6% vs 22/32, 68.8%; p=0.002). Eighteen patients were treated with antibacterial and 14 were treated with antifungal antibiotic in 2016. One patient was lost to follow-up in each group. The rate of TPK was higher and proportion of healed ulcers was lower (p=0.21, Fisher’s exact test) in the group on antifungal therapy (TPK—11/13, 84.6%; Healed—2/13, 15.3%) compared with the group on antibacterial therapy (TPK—11/17, 64.7%; Healed—6/17, 35.2%).ConclusionsWe report favourable but not statistically significant response of P insidiosum keratitis to antibacterial agents in a pilot series of patients. Further evaluation of this strategy in larger number of patients is recommended.

scholarly journals Prostate Cancer Burden at the Uganda Cancer Institute

2016 ◽  
Vol 2 (4) ◽  
pp. 181-185 ◽  
Author(s):  
Fred Okuku ◽  
Jackson Orem ◽  
George Holoya ◽  
Chris De Boer ◽  
Cheryl L. Thompson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Stage Iv ◽  
Cord Compression ◽  
Hormonal Manipulation ◽  
Number Of Patients ◽  
Stage Iv Disease ◽  
Metastatic Sites ◽  
Lost To Follow Up

Purpose In Uganda, the incidence of prostate cancer is increasing at a rate of 5.2% annually. Data describing presentation and outcomes for patients with prostate cancer are lacking. Methods A retrospective review of medical records for men with histologically confirmed prostate cancer at the Uganda Cancer Institute (UCI) from January 1 to December 17, 2012, was performed. Results Our sample included 182 men whose mean age was 69.5 years (standard deviation, 9.0 years). Patients who presented to the UCI had lower urinary tract symptoms (73%; n = 131), bone pain (18%; n = 32), increased prostate-specific antigen (PSA; 3%; n = 5), and other symptoms (6%; n = 11). Median baseline PSA was 91.3 ng/mL (interquartile range, 19.5-311.3 ng/mL), and 51.1% of the patients (n = 92) had a PSA value above 100 ng/mL. Gleason score was 9 or 10 in 66.7% of the patients (n = 120). Ninety percent (n = 136) had stage IV disease, and metastatic sites included bone (73%; n = 102), viscera (21%; n = 29), and lymph nodes (4%; n = 5). Spinal cord compression occurred in 30.9% (n = 55), and 5.6% (n = 10) experienced a fracture. A total of 14.9% (n = 27) underwent prostatectomy, and 17.7% (n = 32) received radiotherapy. Gonadotropin-releasing hormone agonist was given to 45.3% (n = 82), 29.2% (n = 53) received diethylstilbestrol, and 26% (n = 47) underwent orchiectomy. Chemotherapy was administered to 21.6% (n = 39), and 52.5% (n = 95) received bisphosphonates. During the 12 months of study, 23.8% of the men (n = 43) died, and 54.4% (n = 98) were lost to follow-up. Conclusion UCI patients commonly present with high PSA, aggressive Gleason scores, and stage IV disease. The primary treatments are hormonal manipulation and chemotherapy. Almost 25% of patients succumb within a year of presentation, and a large number of patients are lost to follow-up.

scholarly journals Primary care use after cancer treatment: an analysis of linked administrative data

2020 ◽  
Vol 27 (6) ◽  
Author(s):  
R. Urquhart ◽  
L. Lethbridge
Keyword(s):  
Primary Care ◽  
Cancer Survivors ◽  
Negative Binomial ◽  
Census Data ◽  
Gynecologic Cancer ◽  
Negative Binomial Regression ◽  
Cancer Type ◽  
Cancer Centre ◽  
Follow Up Care

Background Primary care–led follow-up is a safe and acceptable alternative to oncologist-led follow-up. We sought to investigate patterns of primary care use during cancer follow-up care. Methods We identified all persons in Nova Scotia, diagnosed with an invasive breast, prostate, colorectal, or gyne­cologic cancer between January 2006 and December 2013. We linked this dataset to cancer centre, hospital discharge abstracts, physicians’ billing, and census data. We identified a survivor cohort (n = 12,201), then descriptively examined primary care use during follow-up care. Multivariate Poisson and negative binomial regression, respectively, were used to examine primary care use for two outcomes: total number of primary care provider (pcp) visits (all reasons) and total number of cancer-specific pcp visits. Results The mean numbers of pcp visits (all reasons) and cancer-specific pcp visits per year for survivors who did not receive cancer centre follow-up (cc-fup) were 8.12 and 0.43 visits, respectively, and for survivors who continued to receive cc-fup were 8.75 and 0.63 visits, respectively. Age, cancer type, stage at diagnosis, comorbidity scores, year of diagnosis, and receipt of cc-fup were associated with both outcomes. Compared with prostate cancer survivors, breast, colorec­tal, and gynecologic cancer survivors had, respectively, 56%, 69%, and 56% fewer expected cancer-specific PCP visits. Receipt of cc-fup increased the expected number of pcp visits (all reasons) by 12% and cancer-specific pcp visits by 50%. Conclusions Primary care use was higher in survivors who continued to visit their oncology teams for follow-up. This suggests that survivors who remain with their oncology teams after treatment continue to have high needs not met by these teams alone.

scholarly journals Effect of a dedicated inferior vena cava filter retrieval program on retrieval rates and number of patients lost to follow-up

2020 ◽  
Vol 26 (1) ◽  
pp. 40-44 ◽  
Author(s):  
Aliaksei Salei ◽  
◽  
Joel Raborn ◽  
Padma Priya Manapragada ◽  
Charles Gresham Stoneburner ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Filter Retrieval ◽  
Number Of Patients ◽  
Lost To Follow Up

Guided Imagery and Music During Active Treatment for Gynecologic Cancer: Results of a feasibility Study

2020 ◽  
Vol 12 (3) ◽  
pp. 199
Author(s):  
Evangelia Papanikolaou ◽  
Cathy McKinney ◽  
Niels Hannibal
Keyword(s):  
Active Treatment ◽  
Guided Imagery ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Hospital Setting ◽  
Structured Interviews ◽  
Guided Imagery And Music ◽  
Greek Hospital

This mixed-methods study investigated the feasibility of a series of short Guided Imagery and Music (GIM) sessions for 4 women with gynecologic cancer undergoing active treatment, in a Greek hospital setting. Pre/post session measurements of HADS, FACT-G, semi-structured interviews following therapy, and therapists’ notes. The women reported pre-post gains for hope and fatigue via 10-point Likert scales, but no consistent changes to self-reported anxiety and depression. In follow-up interviews, all women reported that the music helped them cope with the disease and allowed them to deal with interpersonal and spiritual issues. GIM can be feasible for this population, provided that flexibility on scheduling and location are considered. Keywords: guided imagery and music, gynecologic oncology, quality of life, hope, fatigue 

The effects of a multimodal training program on burnout syndrome in gynecologic oncology nurses and on the multidisciplinary psychosocial care of gynecologic cancer patients: An Italian experience

2012 ◽  
Vol 11 (3) ◽  
pp. 199-203 ◽  
Author(s):  
F.N. Lupo ◽  
Paola Arnaboldi ◽  
L. Santoro ◽  
E. D'Anna ◽  
C. Beltrami ◽  
...  
Keyword(s):  
Training Program ◽  
Multidisciplinary Team ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Psychosocial Care ◽  
Oncology Nurses ◽  
Work Related ◽  
Oncology Service ◽  
Number Of Patients ◽  
Multimodal Training

AbstractObjective:In cancer care, the burden of psycho-emotional elements involved on the patient–healthcare provider relationship cannot be ignored. The aim of this work is to have an impact on the level of burnout experienced by European Institute of Oncology (IEO) gynecologic oncology nurses (N = 14) and on quality of multidisciplinary team work.Method:We designed a 12 session multimodal training program consisting of a 1.5 hour theoretical lesson on a specific issue related to gynecologic cancer patient care, 20 minute projection of a short film, and 1.75 hours of role-playing exercises and experiential exchanges. The Link Burnout Questionnaire (Santinello, 2007) was administered before and after the completion of the intervention. We also monitored the number of patients referred to the Psycho-oncology Service as an indicator of the efficacy of the multidisciplinary approach.Results:After the completion of the program, the general level of burnout significantly diminished (p = 0.02); in particular, a significant decrease was observed in the “personal inefficacy” subscale (p = 0.01). The number of patients referred to the Psycho-oncology Service increased by 50%.Significance of results:Nurses are in the first line of those seeing patients through the entire course of the disease. For this reason, they are at a particularly high risk of developing work-related distress. Structured training programs can be a valid answer to work-related distress, and feeling part of a multidisciplinary team helps in providing patients with better psychosocial care.

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