Adherence to childhood cancer treatment: a prospective cohort study from Northern Vietnam
| Autor: | Bui Ngoc Lan, Anders Castor, Thomas Wiebe, Jacek Toporski, Christian Moëll, Lars Hagander |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: | |
| Zdroj: | BMJ Open, Vol 9, Iss 8 (2019) |
| Druh dokumentu: | article |
| ISSN: | 2018-0268 2044-6055 |
| DOI: | 10.1136/bmjopen-2018-026863 |
| Popis: | Objectives Global incidence and attention to childhood cancer is increasing and treatment abandonment is a major cause of treatment failure in low- and middle-income countries. The purpose of this study was to gain an understanding of factors contributing to non-adherence to treatment.Design A prospective cohort study with 2 year follow-up of incidence, family-reported motives and risk factors.Setting The largest tertiary paediatric oncology centre in Northern Vietnam.Participants All children offered curative cancer treatment, from January 2008 to December 2009.Primary and secondary outcome measures Family decision to start treatment was analysed with multivariable logistic regression, and family decision to continue treatment was analysed with a multivariable Cox model. This assessment of non-adherence is thereby methodologically consistent with the accepted definitions and recommended practices for evaluation of treatment abandonment.Results Among 731 consecutively admitted patients, 677 were eligible for treatment and were followed for a maximum 2 years. Almost half the parents chose to decline curative care (45.5%), either before (35.2%) or during (10.3%) the course of treatment. Most parents reported perceived poor prognosis as the main reason for non-adherence, followed by financial constraints and traditional medicine preference. The odds of starting treatment increased throughout the study-period (OR 1.04 per month (1.01 to 1.07), p=0.002), and were independently associated with prognosis (OR 0.51 (0.41 to 0.64), p= |
| Databáze: | Directory of Open Access Journals |
| Externí odkaz: |
|