Pediatric oncology-hematology outreach: Evaluation of patient consultations by teleconferences between Indonesian and Dutch academic hospitals

Pediatric oncology-hematology outreach: Evaluation of patient consultations by teleconferences between Indonesian and Dutch academic hospitals

Blog Article

Background: Improving the quality of care in resource limited settings through an outreach program is challenging.Teleconferencing is increasingly being used and considered Door Handle 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 Paper Filter recommended.

Keywords: Outreach program, Childhood oncology-hematology, Teleconference, Adherence.