Predictors of Loss to Follow-Up Among Pediatric and Adult Hematopoietic Cell Transplantation Survivors: A Report from the Center for International Blood and Marrow Transplant Research

Buchbinder, David; Brazauskas, Ruta; Bo-Subait, Khalid; Ballen, Karen K.; Parsons, Susan K.; John, Tami; Hahn, Theresa; Sharma, Akshay; Steinberg, Amir; D’Souza, Anita; Kumar, Anita J.; Yoshimi, Ayami; Wirk, Baldeep; Shaw, Bronwen E.; Freytes, César O.; Lemaistre, Charles F.; Bredeson, Christopher; Dandoy, Christopher E.; Almaguer, David Gómez; Marks, David I.; Szwajcer, David; Hale, Gregory A.; Schouten, Harry; Hashem, Hasan; Schoemans, Hélène; Murthy, Hemant S.; Lazarus, Hillard M.; Černý, Jan; Tay, Jason; Yared, Jean A.; Adekola, Kehinde; Schultz, Kirk R.; Lehmann, Leslie; Burns, Linda J.; Aljurf, Mahmoud; Díaz, Miguel Ángel; Majhail, Navneet S.; Farhadfar, Nosha; Kamble, Rammurti T.; Olsson, Richard F.; Schears, Raquel M.; Seo, Sachiko; Beattie, Sara; Chhabra, Saurabh; Savani, Bipin N.; Badawy, Sherif M.; Ganguly, Siddhartha; Ciurea, Stefan O.; Marino, Susana R.; Gergis, Usama; Kuwatsuka, Yachiyo; Inamoto, Yoshihiro; Khera, Nandita; Hashmi, Shahrukh K.; Wood, William A.; Saber, Wael

doi:10.1016/j.bbmt.2019.11.003

Cited by 14 publications

(11 citation statements)

References 35 publications

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“…Contrary to our initial hypothesis, we found long driving distance to be a superior predictor of LTF among HCT survivors compared to annualized interaction frequencies (encompassing both in-person appointments and telemedicine encounters). Compared to a recent multicenter CIBMTR analysis demonstrating a 5% rate of LTF 5 years after allogeneic HCT [1], our corresponding 6% LTF rate with median follow-up of 49 months was similar. Additionally, our findings were consistent with the CIBMTR's models, suggesting that driving distances of 100+ miles and public insurance status were associated with LTF.…”

Section: Discussionsupporting

confidence: 74%

“…Data were collected between January 1, 2002 and June 30, 2018. To mirror CIBMTR classifications at this stage of survivorship, we defined LTF as the absence of follow‐up for 2+ years [ 1 ]. However, we defined follow‐up more broadly to include any form of patient interaction; this term included both in‐person appointments and telemedicine encounters (as delineated based upon encounter codes entered by clinics).…”

Section: Methodsmentioning

confidence: 99%

“…Allogeneic hematopoietic cell transplantation (HCT) for hematologic malignancies requires long‐term follow‐up for chronic graft‐versus‐host disease (cGVHD) management and optimal survivorship care. However, in a recent Center for International Blood and Marrow Transplant Research (CIBMTR) analysis, loss to follow‐up (LTF) rates among allogeneic HCT survivors rose to 5% within 5 years of HCT and 13% within 10 years of HCT [ 1 ]. Long geographic distances between patient residences and HCT centers predicted LTF in this analysis; however, data on appointment frequencies were not available for incorporation into CIBMTR regression modeling.…”

Section: Introductionmentioning

confidence: 99%

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Driving distances and loss to follow‐up after hematopoietic cell transplantation

Banerjee

Loren

2021

eJHaem

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In a recent multicenter analysis, long geographic distances predicted loss to followup (LTF) among allogeneic hematopoietic cell transplantation (HCT) survivors. We hypothesized that lower frequencies of patient interactions (including in-person appointments and telemedicine encounters) would predict LTF rather than long driving distances. However, in our retrospective single-center analysis of 263 HCT survivors, the only predictors of LTF were residence in the furthest driving-distance quartile and Medicaid insurance (but not annualized frequencies of patient interactions). Our findings suggest that telemedicine may not necessarily "rescue" long-distance HCT survivors from LTF. Other solutions, for example patient-specific partnerships with local providers, may be helpful. K E Y W O R D S geographic factors, hematopoietic cell transplantation, lost to follow-up, telemedicine How to cite this article: Banerjee R, Loren AW. Driving distances and loss to follow-up after hematopoietic cell

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Section: Discussionsupporting

confidence: 74%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Driving distances and loss to follow‐up after hematopoietic cell transplantation

Banerjee

Loren

2021

eJHaem

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“…However, to better delineate the potential of longer driving distances to create logistical hurdles for patients, we also developed secondary post hoc analyses of driving distance operationalized as a dichotomous binary variable: either fewer than 100 miles (<100 mi) or at least 100 miles (100+ mi). This 100-mile cutoff has been used in previous studies investigating both access to HCT and outcomes after HCT [42,57,63]. While the significance of 100 miles was not explained in these studies, we surmised that patients/caregivers living 100+ miles from their HCT center would likely have to commit their entire days to such appointments given presumed transit times by car exceeding 1.5 hours.…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively, it is possible that the subgroup of long-distance survivors who completed PRO assessments for our baseline analysis may have been more motivated to maintain their mental and physical health than their similarly long-distance peers who had already been lost to follow-up (or who declined enrollment in the INSPIRE study). While speculative, the possibility of selection bias is bolstered by a recent registry-based study by the Center for International Blood and Marrow Transplant Research showing that long driving distances are associated with higher rates of becoming lost to follow-up [63] . Correlative work from previous studies suggests that HCT survivors who drop out of longitudinal studies may have worsened physical health and psychological well-being [ 72 , 73 ].…”

Section: Discussionmentioning

confidence: 99%

Driving Distance and Patient-Reported Outcomes in Hematopoietic Cell Transplantation Survivors

Banerjee

Majhail

et al. 2020

Biology of Blood and Marrow Transplantation

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Long driving distances to transplantation centers may impede access to care for hematopoietic cell transplantation (HCT) survivors. As a secondary analysis from the multicenter INSPIRE study (NCT01602211), we examined baseline data from relapse-free HCT adult survivors (2 to 10 years after allogeneic or autologous HCT) to investigate the association between driving distances and patient-reported outcome (PRO) measures of distress and physical function. We analyzed predictors of elevated distress and impaired physical function using logistic regression models that operationalized driving distance first as a continuous variable and separately as a dichotomous variable (<100 versus 100+ miles). Of 1136 patients available for analysis from 6 US centers, median driving distance was 82 miles and 44% resided 100+ miles away from their HCT centers. Elevated distress was reported by 32% of patients, impaired physical function by 19%, and both by 12%. Driving distance, whether operationalized as a continuous or dichotomous variable, had no impact on distress or physical function in linear regression modeling (95% confidence interval, 1.00 to 1.00, for both PROs with driving distance as a continuous variable). In contrast, chronic graft-versus-host-disease, lower income, and lack of Internet access independently predicted both elevated distress and impaired physical function. In summary, we found no impact of driving distance on distress and physical function among HCT survivors. Our results have implications for how long-term follow-up care is delivered after HCT, with regard to the negligible impact of driving distances on PROs and also the risk of a "digital divide" worsening outcomes among HCT survivors without Internet access.

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Late effects post‐allogeneic hematopoietic stem cell transplantation

Hashmi

Inamoto²

2021

Blood and Marrow Transplantation Long Term Management

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Predictors of Loss to Follow-Up Among Pediatric and Adult Hematopoietic Cell Transplantation Survivors: A Report from the Center for International Blood and Marrow Transplant Research

Cited by 14 publications

References 35 publications

Driving distances and loss to follow‐up after hematopoietic cell transplantation

Driving distances and loss to follow‐up after hematopoietic cell transplantation

Driving Distance and Patient-Reported Outcomes in Hematopoietic Cell Transplantation Survivors

Late effects post‐allogeneic hematopoietic stem cell transplantation

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