How essential are in-person clinic visits during maintenance treatment of children with acute lymphoblastic leukemia?
Pediatr Blood Cancer
; 69(7): e29713, 2022 07.
Article
in English
| MEDLINE | ID: covidwho-1782662
ABSTRACT
BACKGROUND:
Acute lymphoblastic leukemia (ALL) is the most common cancer in children. Treatment consists of an initial intensive phase of chemotherapy, followed by a prolonged period of maintenance chemotherapy intended to reduce the risk of relapse. During the COVID-19 pandemic, the need arose to identify and reduce non-essential hospital visits.OBJECTIVE:
We aimed to determine which proportion of in-person clinic visits during ALL maintenance therapy was associated with a change of management based on the results of the physical examination. PATIENTS ANDMETHODS:
Medical records of children receiving maintenance chemotherapy for B-precursor ALL between September 2019 and February 2020 were reviewed. Visits with a new finding on physical examination were divided into those where an in-person assessment was deemed essential versus not essential. Finally, we determined the proportion of essential in-person visits that resulted in a change of management.RESULTS:
A total of 240 maintenance visits by 75 children were analyzed. An abnormal finding on physical examination was noted during 20 visits (8.3%). Of those, 14 (5.8%) uncovered a new finding, six (2.5%) were classified as "in-person visit essential," and among those six visits, three (1.2%) resulted in a change of patient management (one for acute otitis media, one for wheezing, and one for limp).CONCLUSION:
Our findings support the evaluation of care delivery models other than in-person visits during ALL maintenance therapy. A prospective study is required to delineate criteria, benefits/risks, and families' perspectives associated with virtual care delivery and the optimal frequency of in-person visits.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Telemedicine
/
Precursor Cell Lymphoblastic Leukemia-Lymphoma
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Child
/
Humans
Language:
English
Journal:
Pediatr Blood Cancer
Journal subject:
Hematology
/
Neoplasms
/
Pediatrics
Year:
2022
Document Type:
Article
Affiliation country:
Pbc.29713
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