Failure to attend appointments and loss to follow-up: a prospective study of patients with malignant lymphoma in Riyadh, Saudi Arabia

Failure to attend medical appointments (No Show) and loss to follow-up (LTFU) among patients with cancer can adversely affect their treatment and eventual outcome. In a 3-year prospective study of 199 patients with malignant lymphoma, all of those with No Shows were contacted, and reasons given for No Shows were categorized. Of the 340 No Shows, 34.1% were due to hospital-based communication problems, 17.6% to errors in patient communication with the hospital, 7.4% to transportation problems and 16.5% to other personal reasons. Almost one quarter (24.4%) of the patients were not contactable. Reasons for No Show in all categories were instructive as to patients' attitudes to treatment. Nineteen (12.2%) of the 156 patients who had not died in the 3-year follow-up period were identified as LTFU. These 19 LTFU patients accounted for 77 (22.6%) of all No Shows. The data indicate that LTFU in this cohort is significantly less frequent than in a prior cohort followed up for 3 years from 1997 to 1998. These findings suggest that some causes of No Show can be addressed, and individuals are identified as at particular risk for No Show and ultimately LTFU. This study points out that pre-emptive strategies to reduce No Shows may be feasible and efficacious.     

An epidemiological study to identify the risk factors with two different types of controls in high-grade cervical lesions including invasive cancer

A multidisciplinary study on pre-cancerous and early cancerous lesions of uterine cervix was carried out at our Institute from which the subjects (cases and one group of control) for the present study were selected with the objective to identify the possible risk factors related to high-grade cervical lesions including invasive cancer through an epidemiological study by selecting two different types of controls and to assess the feasibility whether the cancers of other organs could be taken as controls at the same time studying the risk factors associated with cervical cancer. One group of control was women with negative Pap smear and second group of control was the women with breast cancer but negative Pap smear. A total of 100 biopsy-proven cases of high-grade cervical intraepithelial lesions and Invasive cancer were recruited. The results of the study show that some of the risk factors associated with the cervical cancer get exaggerated when breast cancer cases were used as controls because risk factors of both cancers are opposite to each other. So it is concluded that in order to remove any bias, normal hospital controls or controls selected from multiple cancers should be taken to study the risk factors involved in cervical carcinogenesis.     

Academic pharmacy practice units: Their development and role in England

The benefits to be gained from closer relationships between academia and practice were given official endorsement in Britain in the independent Nuffield report into pharmacy and in a circular issued by the Department of Health. Hospital based academic pharmacy practice units (APPUs) were recommended. This paper examines the planning and development of such units and the threats and opportunities presented. The experiences gained in directing a hospital-based unit serving a complete region (Mersey) are provided. Nationally it is shown that APPUs differ in rate of development, organisational structure, relationships and financial support. Their differences are outweighed by their common purpose to improve pharmacy practice by linking academia and practice.     

Salivary gland dysfunction (‘dry mouth’) in patients with cancer: a consensus statement

DAVIES A., BAGG J., LAVERTY D., SWEENEY P., FILBET M., NEWBOLD K., DE ANDRÉS J. & MERCADANTE S. (2010) European Journal of Cancer Care 19 , 172–177
Salivary gland dysfunction (‘dry mouth’) in patients with cancer: a consensus statement A group of interested professionals was convened to develop some evidence‐based recommendations on the management of salivary gland dysfunction (SGD) in oncology patients. A Medline search was performed to identify the literature on SGD. The abstracts of all identified papers were read, and the full texts of all relevant papers were reviewed. The evidence was graded according to the Scottish Intercollegiate Guidelines Network grading system for recommendations in evidence‐based guidelines. The summary of the main recommendations are: (1) patients with cancer should be regularly assessed for SGD (grade of recommendation – D); (2) the management of SGD should be individualised (D); (3) consideration should be given to strategies to prevent the development of radiation‐induced SGD (C); (4) consideration should be given to treatment of the cause(s) of the SGD (C); (5) the treatment of choice for the symptomatic management of SGD is use of an appropriate saliva stimulant (C); (6) consideration should be given to prevention of the complications of the SGD (D); (7) consideration should be given to treatment of the complications of the SGD (D); and (8) patients with SGD should be regularly reassessed (D).