Evaluation of safety tool for ambulatory leprosy patients at risk of adverse outcome
Abstract Background Leprosy is a potentially debilitating disease of the skin and nerves that requires a complex management approach consisting of laboratory monitoring, screening for factors that will adversely affect outcome with corticosteroids, engagement of allied health services, and prolonged...
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ftdoajarticles:oai:doaj.org/article:181e6081df864f9db7fa9eba491134d4 2023-05-15T15:12:22+02:00 Evaluation of safety tool for ambulatory leprosy patients at risk of adverse outcome Cara MacRae Swana Kopalakrishnan Lena Faust Michael Klowak Adrienne Showler Stefanie A. Klowak Andrea K. Boggild 2018-03-01T00:00:00Z https://doi.org/10.1186/s40794-018-0061-9 https://doaj.org/article/181e6081df864f9db7fa9eba491134d4 EN eng BMC http://link.springer.com/article/10.1186/s40794-018-0061-9 https://doaj.org/toc/2055-0936 doi:10.1186/s40794-018-0061-9 2055-0936 https://doaj.org/article/181e6081df864f9db7fa9eba491134d4 Tropical Diseases, Travel Medicine and Vaccines, Vol 4, Iss 1, Pp 1-7 (2018) Leprosy Mycobacterium leprae Reactions Quality improvement Safety tool Arctic medicine. Tropical medicine RC955-962 article 2018 ftdoajarticles https://doi.org/10.1186/s40794-018-0061-9 2022-12-31T14:45:28Z Abstract Background Leprosy is a potentially debilitating disease of the skin and nerves that requires a complex management approach consisting of laboratory monitoring, screening for factors that will adversely affect outcome with corticosteroids, engagement of allied health services, and prolonged follow-up. Given the complexities of leprosy management, a safety tool was developed and implemented in the Tropical Disease Unit at Toronto General Hospital. Our objective was to evaluate the utility of the tool using a retrospective chart review. Methods We reviewed the charts of patients with leprosy treated over a 3.5-year period: up to 3 years prior to tool implementation, and 6-months following implementation. Pre-determined outcomes of interest included: loss to follow-up; monitoring of laboratory parameters; allied health services engagement; baseline ophthalmologic assessment; and risk mitigation interventions. Results Of 17 patients enrolled, 8 were treated pre-implementation, and 9 post-implementation. Five (29.4%) pre-implementation patients were lost to follow-up compared to none post-implementation (p = 0.009). One (12.5%) pre-implementation patient was sent for baseline ophthalmologic assessment versus 8 (88.9%) post-implementation (p = 0.0034). Only post-implementation patients received referrals for occupational therapy and social work, with 77.8% (n = 7) receiving occupational therapy (p = 0.0023) and 33.3% (n = 3) social work (p = 0.2059). Laboratory parameters such as hemoglobin, hepatic transaminases, and methemoglobin were routinely monitored for patients on dapsone irrespective of tool implementation. Conclusions Implementation of a leprosy-specific safety tool has established a user-friendly method for systemizing all elements of care, and ensuring the involvement of allied health services necessary for optimizing health outcomes. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Tropical Diseases, Travel Medicine and Vaccines 4 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Leprosy Mycobacterium leprae Reactions Quality improvement Safety tool Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
Leprosy Mycobacterium leprae Reactions Quality improvement Safety tool Arctic medicine. Tropical medicine RC955-962 Cara MacRae Swana Kopalakrishnan Lena Faust Michael Klowak Adrienne Showler Stefanie A. Klowak Andrea K. Boggild Evaluation of safety tool for ambulatory leprosy patients at risk of adverse outcome |
topic_facet |
Leprosy Mycobacterium leprae Reactions Quality improvement Safety tool Arctic medicine. Tropical medicine RC955-962 |
description |
Abstract Background Leprosy is a potentially debilitating disease of the skin and nerves that requires a complex management approach consisting of laboratory monitoring, screening for factors that will adversely affect outcome with corticosteroids, engagement of allied health services, and prolonged follow-up. Given the complexities of leprosy management, a safety tool was developed and implemented in the Tropical Disease Unit at Toronto General Hospital. Our objective was to evaluate the utility of the tool using a retrospective chart review. Methods We reviewed the charts of patients with leprosy treated over a 3.5-year period: up to 3 years prior to tool implementation, and 6-months following implementation. Pre-determined outcomes of interest included: loss to follow-up; monitoring of laboratory parameters; allied health services engagement; baseline ophthalmologic assessment; and risk mitigation interventions. Results Of 17 patients enrolled, 8 were treated pre-implementation, and 9 post-implementation. Five (29.4%) pre-implementation patients were lost to follow-up compared to none post-implementation (p = 0.009). One (12.5%) pre-implementation patient was sent for baseline ophthalmologic assessment versus 8 (88.9%) post-implementation (p = 0.0034). Only post-implementation patients received referrals for occupational therapy and social work, with 77.8% (n = 7) receiving occupational therapy (p = 0.0023) and 33.3% (n = 3) social work (p = 0.2059). Laboratory parameters such as hemoglobin, hepatic transaminases, and methemoglobin were routinely monitored for patients on dapsone irrespective of tool implementation. Conclusions Implementation of a leprosy-specific safety tool has established a user-friendly method for systemizing all elements of care, and ensuring the involvement of allied health services necessary for optimizing health outcomes. |
format |
Article in Journal/Newspaper |
author |
Cara MacRae Swana Kopalakrishnan Lena Faust Michael Klowak Adrienne Showler Stefanie A. Klowak Andrea K. Boggild |
author_facet |
Cara MacRae Swana Kopalakrishnan Lena Faust Michael Klowak Adrienne Showler Stefanie A. Klowak Andrea K. Boggild |
author_sort |
Cara MacRae |
title |
Evaluation of safety tool for ambulatory leprosy patients at risk of adverse outcome |
title_short |
Evaluation of safety tool for ambulatory leprosy patients at risk of adverse outcome |
title_full |
Evaluation of safety tool for ambulatory leprosy patients at risk of adverse outcome |
title_fullStr |
Evaluation of safety tool for ambulatory leprosy patients at risk of adverse outcome |
title_full_unstemmed |
Evaluation of safety tool for ambulatory leprosy patients at risk of adverse outcome |
title_sort |
evaluation of safety tool for ambulatory leprosy patients at risk of adverse outcome |
publisher |
BMC |
publishDate |
2018 |
url |
https://doi.org/10.1186/s40794-018-0061-9 https://doaj.org/article/181e6081df864f9db7fa9eba491134d4 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Tropical Diseases, Travel Medicine and Vaccines, Vol 4, Iss 1, Pp 1-7 (2018) |
op_relation |
http://link.springer.com/article/10.1186/s40794-018-0061-9 https://doaj.org/toc/2055-0936 doi:10.1186/s40794-018-0061-9 2055-0936 https://doaj.org/article/181e6081df864f9db7fa9eba491134d4 |
op_doi |
https://doi.org/10.1186/s40794-018-0061-9 |
container_title |
Tropical Diseases, Travel Medicine and Vaccines |
container_volume |
4 |
container_issue |
1 |
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1766343062910402560 |