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Compliance with anti-infective preventive measures: A multicentre survey among paediatric oncology patients
Thomas Lehrnbecher1, Hans-Jürgen Laws, Alexandra Boehm
1Paediatric Haematology and Oncology, Children's Hospital III, Johann Wolfgang Goethe-University, University of Frankfurt, Theodor-Stern-Kai 7, D-60590 Frankfurt, Germany. Thomas.Lehrnbecher@kgu.de
Insights
Pediatric cancer patients show variable adherence to infection prevention strategies. Compliance is linked to factors like hematological malignancy, younger age, and belief in intervention effectiveness.
Area of Science:
- Pediatric Oncology
- Infectious Disease Prevention
- Healthcare Adherence
Background:
- Infections pose significant risks for immunocompromised pediatric cancer patients.
- Understanding adherence to preventive anti-infective interventions is crucial but limited in this population.
Purpose of the Study:
- To assess compliance rates with preventive anti-infective interventions in pediatric cancer patients undergoing intensive anticancer therapy.
- To explore factors influencing adherence, including patient/caretaker beliefs and satisfaction with information.
Main Methods:
- A voluntary, anonymized questionnaire assessed adherence to eight preventive interventions.
- Semi-quantitative scoring evaluated patient/caretaker adherence.
- Statistical analyses explored correlations between compliance and demographic/belief factors.
Main Results:
- Compliance rates varied, with highest adherence for food restriction (89.3%) and lowest for social contact restrictions (65.5%).
- Common reasons for non-compliance included forgetfulness and patient refusal.
- Compliance was associated with hematological malignancy, younger age, and belief in intervention efficacy.
Conclusions:
- Adherence to anti-infective prophylaxis in pediatric cancer patients is inconsistent.
- Hematological malignancy, younger age, and belief in efficacy are key correlates of compliance.
Background:
Infections are significant causes of morbidity and mortality among immunocompromised patients, but little is known about the adherence by the paediatric cancer patients to preventive anti-infective interventions.
Methods:
A voluntary and anonymised questionnaire was distributed to all patients, completing intensive anticancer therapy. Compliance was analysed by using a panel of eight commonly recommended preventive interventions and semi-quantitative scoring of adherence by the patient and/or its caretaker. Satisfaction with information and belief in the efficacy of the interventions were similarly assessed. Relationships of these factors to compliance were explored by using an overall compliance score and non-parametric correlation and/or ANOVA and logistic regression, respectively.
Results:
In 216 children and adolescents (mean age: 8 years; 94 girls) included in the study, compliance rates were the highest for food restriction (89.3%), the use of topic antimycotics (88.2%) and trimethoprim/sulfamethoxazole (86.6%), and the lowest for the use of face masks (68.8%), antiseptic mouth rinses (67.1%), non-absorbable antibiotic agents (66.5%) and restrictions in social contacts (65.5%). The most frequent reasons for drug non-compliance were forgetfulness and patient refusal. Compliance correlated with haematological malignancy, younger age and belief in its efficacy, but not with the perceived degree of information, burden of interventions and overall satisfaction with quality of information and medical care.
Conclusion:
Compliance to recommended anti-infective prophylactic interventions was variable and correlated with haematological malignancy, younger age and belief in efficacy.
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