A questionnaire study of support for adult survivors of childhood cancer.

BACKGROUND: Childhood cancer survivors (CCSs) entering adulthood experience different problems, including late therapy-related complications. Long-term follow up (LTFU) is important for early intervention and psychosocial support for CCSs with late complications but it is frequently discontinued. This study aimed (i) to identify clearly the factors responsible for LTFU discontinuation, and (ii) to define the support needs of CCSs. METHODS: From July, 2017 to March, 2019 we conducted a questionnaire survey of 121 CCSs aged ≥ 18 years at the time of the survey to investigate people who have experienced childhood cancer and identify their support needs. This was conducted in cooperation with patient associations throughout Japan. The LTFU levels were determined by CCSs themselves based on their treatment history. Long-term follow-up rates and LTFU discontinuation factors were assessed using the Kaplan-Meier method and the Cox proportional-hazards model. RESULTS: Late complications were the most common problem encountered by CCSs (80%). The most common support need was "explanation of late complications by a physician," reported by 86.9% of respondents. The rate of LTFU continuation decreased over time. The LTFU was discontinued both for physicians' reasons (35.6%) and patients' reasons (64.4%). Not knowing the extent or level of one's LTFU was reported to be an independent factor (P < 0.05) preventing LTFU continuation. As necessary support to continue LTFU, 67.9% of respondents stated the need for "explanation of LTFU by a doctor" and 60.7% stated "convenience of outpatient visit". CONCLUSIONS: Childhood cancer survivors require support, especially for late complications. It is necessary to continue LTFU, raising LTFU awareness among physicians and CCSs.

[Development of an Informative System for Consumers and Pharmacists Aimed at the Proper Use of Kampo OTCs].

Kampo medicines must be used according to an individual's physical characteristics and symptoms to avoid lack of efficacy, adverse reactions or interactions with other drugs. As category-2 over-the-counter drugs (OTCs), Kampo OTCs are not targets of active explanations by pharmacists, and consumers usually decide to use OTCs by themselves on the basis of drug label information. However, information on the label is occasionally brief. To promote the proper use of Kampo OTCs, we herein propose an informative tool based on the Australian Shelf-Talker (information on the proper use of OTCs with a self-check questionnaire for consumers), the Self-Check Card (SCC). We also prepared the informative material, Information to the Pharmacist (IP), directed at pharmacists regarding these Kampo OTCs. We created SCCs and IPs for 16 prescriptions in the 5 most demanded categories (cold, cough/sore throat, urination problems, women's diseases, and shoulder stiffness or joint/nerve pain). The SCC with questions in a simplified language specifies individuals who should avoid the drug, or those who should consult a pharmacist before purchase, according to the safety information on the respective drug labels. The IP provides information to pharmacists on safety issues and those concerning recognition of the consumer's symptoms and physical characteristics needed for the selection of appropriate Kampo OTCs. Such SCCs and IPs are now in use in 2 pharmacies to know pharmacists' suggestions about improvements and consumer's opinions and degree of satisfaction. We believe these risk-benefit communication tools, SCC and IP, will contribute to improve the proper use of Kampo OTCs.