Addressing Treatment Abandonment in Pediatric Oncology: The Role of Missed Appointment Call-Back Systems in a Pakistani Setting

Objective: To evaluate the effectiveness of a missed appointment call-back system in reducing treatment abandonment rates at a tertiary care hospital in Pakistan. Methods: This cross-sectional study was conducted in the Pediatric Hematology and Oncology Department of Indus Hospital and Health Netwo...

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Main Authors: Neelum Tahirkheli, Sadia Imran, Fauzia Ahmed, Muhammad Rafi Raza, Zaman Khan, Shabnam Munir, Muhammad Shamvil Ashraf, Syed Ahmed Hamid
Format: Article
Language:English
Published: Dow University of Health Sciences 2024-12-01
Series:Journal of the Dow University of Health Sciences
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Online Access:https://jduhs.jduhs.duhs.edu.pk/index.php/jduhs/article/view/2194
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author Neelum Tahirkheli
Sadia Imran
Fauzia Ahmed
Muhammad Rafi Raza
Zaman Khan
Shabnam Munir
Muhammad Shamvil Ashraf
Syed Ahmed Hamid
author_facet Neelum Tahirkheli
Sadia Imran
Fauzia Ahmed
Muhammad Rafi Raza
Zaman Khan
Shabnam Munir
Muhammad Shamvil Ashraf
Syed Ahmed Hamid
author_sort Neelum Tahirkheli
collection DOAJ
description Objective: To evaluate the effectiveness of a missed appointment call-back system in reducing treatment abandonment rates at a tertiary care hospital in Pakistan. Methods: This cross-sectional study was conducted in the Pediatric Hematology and Oncology Department of Indus Hospital and Health Network from April to September 2023. The study included children aged 1 month to 16 years diagnosed with cancer and receiving curative treatment. A call-back system was introduced, contacting patients within 48 hours of a missed appointment to address their absence and reschedule. Treatment abandonment was defined as missing clinic visits for 4 weeks. Results: Of 389 children, the mean age was 6.8 ±4.0 years. There were 258 (66.3%) males and 131 (33.6%) females. Treatment abandonment was observed in 26 (6.7%) patients. The likelihood of treatment abandonment was 6 times significantly higher in children who did not respond to the call than those who did respond (cOR 6.27, 95% CI 2.69 to 14.59, p-value <0.001). Similarly, children who missed rescheduled appointments had 8 times higher chances of treatment abandonment than those who attended (cOR 8.11, 95% CI 3.30 to 19.92, p-value <0.001). Among 26 treatment abandonment children, the most common reason of missed appointment was financial issue 10 (38.5%) followed by forget appointment 7 (26.9%), attending school 6 (23.1%), and long distance 3 (11.5%). Conclusion: Treatment abandonment was low as 6.7%. Children who did not respond to call-backs or missed rescheduled appointments were significantly more likely to abandon treatment. The call-back system is effective in reducing abandonment rates in pediatric oncology.
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spelling doaj-art-e5cc800c45d44b218f99b43b7f13ae062025-08-20T02:49:26ZengDow University of Health SciencesJournal of the Dow University of Health Sciences1995-21982410-21802024-12-01183Addressing Treatment Abandonment in Pediatric Oncology: The Role of Missed Appointment Call-Back Systems in a Pakistani SettingNeelum Tahirkheli0Sadia Imran1Fauzia Ahmed2Muhammad Rafi Raza3Zaman Khan4Shabnam Munir5Muhammad Shamvil Ashraf6Syed Ahmed Hamid7Department of Paediatric Haematology Oncology, Indus Hospital and Health Network, Karachi.Department of Paediatric Haematology Oncology, Indus Hospital and Health Network, Karachi.Department of Paediatric Haematology Oncology, Indus Hospital and Health Network, Karachi.Department of Paediatric Haematology Oncology, Indus Hospital and Health Network, Karachi.Department of Paediatric Haematology Oncology, Indus Hospital and Health Network, Karachi.Department of Paediatric Haematology Oncology, Indus Hospital and Health Network, Karachi.Department of Paediatric Haematology Oncology, Indus Hospital and Health Network, Karachi.Department of Paediatric Haematology Oncology, Indus Hospital and Health Network, Karachi. Objective: To evaluate the effectiveness of a missed appointment call-back system in reducing treatment abandonment rates at a tertiary care hospital in Pakistan. Methods: This cross-sectional study was conducted in the Pediatric Hematology and Oncology Department of Indus Hospital and Health Network from April to September 2023. The study included children aged 1 month to 16 years diagnosed with cancer and receiving curative treatment. A call-back system was introduced, contacting patients within 48 hours of a missed appointment to address their absence and reschedule. Treatment abandonment was defined as missing clinic visits for 4 weeks. Results: Of 389 children, the mean age was 6.8 ±4.0 years. There were 258 (66.3%) males and 131 (33.6%) females. Treatment abandonment was observed in 26 (6.7%) patients. The likelihood of treatment abandonment was 6 times significantly higher in children who did not respond to the call than those who did respond (cOR 6.27, 95% CI 2.69 to 14.59, p-value <0.001). Similarly, children who missed rescheduled appointments had 8 times higher chances of treatment abandonment than those who attended (cOR 8.11, 95% CI 3.30 to 19.92, p-value <0.001). Among 26 treatment abandonment children, the most common reason of missed appointment was financial issue 10 (38.5%) followed by forget appointment 7 (26.9%), attending school 6 (23.1%), and long distance 3 (11.5%). Conclusion: Treatment abandonment was low as 6.7%. Children who did not respond to call-backs or missed rescheduled appointments were significantly more likely to abandon treatment. The call-back system is effective in reducing abandonment rates in pediatric oncology. https://jduhs.jduhs.duhs.edu.pk/index.php/jduhs/article/view/2194Pediatric cancerTreatment abandonmentcall-back systemPakistanoncology
spellingShingle Neelum Tahirkheli
Sadia Imran
Fauzia Ahmed
Muhammad Rafi Raza
Zaman Khan
Shabnam Munir
Muhammad Shamvil Ashraf
Syed Ahmed Hamid
Addressing Treatment Abandonment in Pediatric Oncology: The Role of Missed Appointment Call-Back Systems in a Pakistani Setting
Journal of the Dow University of Health Sciences
Pediatric cancer
Treatment abandonment
call-back system
Pakistan
oncology
title Addressing Treatment Abandonment in Pediatric Oncology: The Role of Missed Appointment Call-Back Systems in a Pakistani Setting
title_full Addressing Treatment Abandonment in Pediatric Oncology: The Role of Missed Appointment Call-Back Systems in a Pakistani Setting
title_fullStr Addressing Treatment Abandonment in Pediatric Oncology: The Role of Missed Appointment Call-Back Systems in a Pakistani Setting
title_full_unstemmed Addressing Treatment Abandonment in Pediatric Oncology: The Role of Missed Appointment Call-Back Systems in a Pakistani Setting
title_short Addressing Treatment Abandonment in Pediatric Oncology: The Role of Missed Appointment Call-Back Systems in a Pakistani Setting
title_sort addressing treatment abandonment in pediatric oncology the role of missed appointment call back systems in a pakistani setting
topic Pediatric cancer
Treatment abandonment
call-back system
Pakistan
oncology
url https://jduhs.jduhs.duhs.edu.pk/index.php/jduhs/article/view/2194
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