Pediatric oncology-hematology outreach: Evaluation of patient consultations by teleconferences between Indonesian and Dutch academic hospitals
| Autor: | E. Kelling, B.W. Indraswari, M. A. Veening, Mei Neni Sitaresmi, Gertjan J.L. Kaspers, Eddy Supriyadi, Krisna Handayani, Saskia Mostert, W.A. Kors, Anjo J.P. Veerman |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Medical record lcsh:RJ1-570 Physical examination Computed tomography lcsh:Pediatrics Hematology language.human_language Active participation Outreach Indonesian 03 medical and health sciences 0302 clinical medicine Oncology 030220 oncology & carcinogenesis Family medicine Pediatrics Perinatology and Child Health medicine language 030212 general & internal medicine Pediatric hematology business Limited resources |
| Zdroj: | Pediatric Hematology Oncology Journal, Vol 3, Iss 4, Pp 102-108 (2018) |
| ISSN: | 2468-1245 |
| Popis: | Background: Improving the quality of care in resource limited settings through an outreach program is challenging. Teleconferencing is increasingly being used and considered a breakthrough in medical education. We evaluated adherence with childhood oncology-hematology teleconferences between two academic hospitals in Indonesia and Netherlands. Methods: Teleconferences held during 12 months between an Indonesian and a Dutch academic hospital were evaluated using a standardized form. Both adherence with diagnostic and treatment advices for individual patients were explored in medical records. Results: During 38 teleconferences, difficult cases of 53 children were discussed by Dutch pediatric oncologists and Indonesian residents. Dutch oncologists advised diagnostic adjustments in 41 cases (77%). Most common diagnostic advices were: laboratory tests (68%), imaging (54%), physical examination (41%). Diagnostic advices were not adhered to in 12 children (30%). Common reasons for non-adherence were: not applicable in middle-income setting (25%), disagreement with Dutch advice (17%), CT scan is out of order (17%), patient died (17%). Dutch oncologists advised treatment adjustments in 40 cases (75%). Most common treatment advices were: change of protocol (38%), nutritional support (30%), prevention of tumor lysis syndrome (20%). Treatment advices were not adhered to in 9 children (22%). Common reasons for non-adherence were: poor condition of child (44%), not applicable in middle-income setting (22%), patient died (22%), disagreement with Dutch advice (11%). Twenty-four children (45%) died after teleconference was held. Twenty-nine children (55%) were alive. These children abandoned (38%), completed (31%) or were still under treatment (31%). Conclusion: Through teleconferencing, knowledge between high and low or middle-income countries can be shared to improve patient care. Locally applicable advices are required. Active participation by pediatric oncologists at both partner sites is recommended. Keywords: Outreach program, Childhood oncology-hematology, Teleconference, Adherence |
| Databáze: | OpenAIRE |
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