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Barriers to long-term follow-up in pediatric Hodgkin lymphoma survivors.
Tinsley, Hailey; Gramatges, Maria; Dreyer, ZoAnn; Okcu, M Fatih; Shakeel, Omar.
Afiliación
  • Tinsley H; Baylor College of Medicine, Houston, Texas, USA.
  • Gramatges M; Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
  • Dreyer Z; Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
  • Okcu MF; Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
  • Shakeel O; Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Pediatr Blood Cancer ; 71(4): e30855, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38200619
ABSTRACT
BACKGROUND/

PURPOSE:

Pediatric Hodgkin lymphoma (HL) survivors have an increased risk of late effects following treatment. Barriers at the patient, provider, and payor level adversely affect adherence to long-term follow-up.

METHODS:

We conducted a retrospective chart review of HL survivors diagnosed from 1999 to 2014 at Texas Children's Hospital. HL survivors were considered lost to follow-up if there were no documented visits to Texas Children's Cancer Center Long-Term Survivor (LTS) clinic for 2 or more years after their last LTS clinic visit. Univariate and multivariable logistic regression analyses were conducted to explore factors contributing to loss to follow-up. Reasons for not attending subsequent LTS visits were assessed by phone interviews in a subset of lost to follow-up patients.

RESULTS:

There were 120 HL survivors who had at least one LTS clinic visit in this timeframe; 64 (53%) were classified as lost to follow-up, and of these, 23 (36%) were interviewed. Eleven (47%) indicated that the reason for failure to follow-up was lack of or inadequate insurance, and seven (30%) stated they were unaware of the importance of continued follow-up. Loss to follow-up was associated with lack of insurance, earlier diagnosis, and lack of comorbidities in univariate analyses. Only earlier year of diagnosis (odds ratio [OR] 0.84, 95% confidence interval [CI] 0.7-0.9, p = .01) and lack of insurance (OR 22.2, 95% CI 4-123, p < .001) were associated with loss to follow-up in multivariable analyses.

CONCLUSIONS:

Insurance status and awareness of the need for long-term follow-up care are key factors associated with loss to follow-up in survivors of HL. Targeted education and low-cost options for survivorship care are potential strategies for improving adherence to long-term follow-up care in HL survivors.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Hodgkin Límite: Child / Humans Idioma: En Revista: Pediatr Blood Cancer Asunto de la revista: HEMATOLOGIA / NEOPLASIAS / PEDIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Hodgkin Límite: Child / Humans Idioma: En Revista: Pediatr Blood Cancer Asunto de la revista: HEMATOLOGIA / NEOPLASIAS / PEDIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos