International Clinical Neuroscience Journal

Vol. 7 No. 4 (2020)

Leaving Against Medical Advice Among Patients With Brain Tumours in the Middle East: Khoula Hospital Experience

International Clinical Neuroscience Journal, Vol. 7 No. 4 (2020), 28 September 2020 , Page 179-184

Abstract

Background: Leaving against medical advice (LAMA) can be defined broadly as a patient’s insistence upon leaving the hospital against the treating team has expressed advice, which is both a challenge and concern for physicians, as these patients lost to follow-up, and their outcomes remain unknown. There is no previous study conducted to find the prevalence and causes of LAMA in brain tumors patients in the Middle East to the best of our knowledge.
Methods: Patients studied in this research are those who were diagnosed with any type of brain tumors and were admitted to the Neurosurgical Department in Khoula Hospital (KH) but signed LAMA in the two years between January 2017 to December 2018 by going through the electronic medical records. Data obtained from the health information system includes socioeconomic characteristics, health status-related data, diagnosis-related data, and the reasons for LAMA.
Results: A total number of 302 patients with brain tumors included in this study. Twenty-eight patients (9.2%) signed LAMA with a majority of those who signed LAMA were in the young adult’s group (3-39 years) and represented 18 (64%). Eight patients (28.57%) among the LAMA group and 43 patients (15.69%) in the non-LAMA group have tumors in the frontal lobe, which has found to be the most familiar location (29%). There was a significant relationship between the reason for LAMA and gender (P = 0.020).
Conclusion: Younger patients, male, Omani, newly diagnosed tumors, and tumors in the frontal lobe were all risk factors for LAMA. Education and awareness about LAMA recommended in order to avoid readmission and loss of follow up.

Keywords:
  • Tumor
  • Brain
  • leaving
  • Medical Advice
  • Oman
  • LAMA

How to Cite

1.
Al-Saadi T, Al Sharqi A, ALSharqi J, ALBlushi K, ALRasbi A, Al-Farsi M, Al-Ghafri S, Al-Abri S, Al-Saadi H. Leaving Against Medical Advice Among Patients With Brain Tumours in the Middle East: Khoula Hospital Experience. Int Clin Neurosci J [Internet]. 2020 Sep. 28 [cited 2025 Mar. 15];7(4):179-84. Available from: https://journals.sbmu.ac.ir/neuroscience/article/view/30700

References

Ding R, Jung JJ, Kirsch TD, Levy F, McCarthy ML. Uncompleted emergency department care: patients who leave against medical advice. Acad Emerg Med. 2007;14(10):870-6. doi: 10.1197/j.aem.2007.06.027.

McKinney PA. Brain tumours: incidence, survival, and aetiology. J Neurol Neurosurg Psychiatry. 2004;75 Suppl 2(Suppl 2):ii12-7. doi: 10.1136/jnnp.2004.040741.

World Health Organization (WHO). Key Statistics. WHO; 2020. [cited 30 June 2020]. Available from: https://www.who. int/cancer/resources/keyfacts/en/.

Ayed IA. What makes patients leave against medical advice? J Taibah Univ Med Sci. 2009;4(1):16-22. doi: 10.1016/S1658- 3612(09)70077-0.

Ramakrishnan N, Ranganathan L, Abraham BK, Rajagopalan S, Venkataraman R. What happens to patients discharged against medical advice? Indian J Crit Care Med. 2018;22(8):580-4. doi: 10.4103/ijccm.IJCCM_101_18.

Alfandre DJ. “I’m going home”: discharges against medical advice. Mayo Clin Proc. 2009;84(3):255-60. doi: 10.1016/ s0025-6196(11)61143-9.

Franks P, Meldrum S, Fiscella K. Discharges against medical advice: are race/ethnicity predictors? J Gen Intern Med. 2006;21(9):955-60. doi: 10.1111/j.1525-1497.2006.00505.x.

Brook M, Hilty DM, Liu W, Hu R, Frye MA. Discharge against medical advice from inpatient psychiatric treatment: a literature review. Psychiatr Serv. 2006;57(8):1192-8. doi: 10.1176/ps.2006.57.8.1192.

Mishra G, Al Saadi T, Salhotra N, Biniwale S, Hadad M, Hashim M et al. Brain and spinal tumors incidence annual audit 2017 of Dept of Neurosurgery Khoula Hospital Muscat Oman: a review. Am J Med Case Rep. 2018;6(7):128-31. doi: 10.12691/ajmcr-6-7-2.

Noohi K, Komsari S, Nakhaee N, Yazdi Feyzabadi V. Reasons for discharge against medical advice: a case study of emergency departments in Iran. Int J Health Policy Manag. 2013;1(2):137-42. doi: 10.15171/ijhpm.2013.25.

Al-Ghafri M, Al-Bulushi A, Al-Qasmi A. Prevalence of and reasons for patients leaving against medical advice from paediatric wards in Oman. Sultan Qaboos Univ Med J. 2016;16(1):e74-7. doi: 10.18295/squmj.2016.16.01.013.

Ibrahim SA, Kwoh CK, Krishnan E. Factors associated with patients who leave acute-care hospitals against medical advice. Am J Public Health. 2007;97(12):2204-8. doi: 10.2105/ajph.2006.100164.

Lee CA, Cho JP, Choi SC, Kim HH, Park JO. Patients who leave the emergency department against medical advice. Clin Exp Emerg Med. 2016;3(2):88-94. doi: 10.15441/ceem.15.015.

Weingart SN, Davis RB, Phillips RS. Patients discharged against medical advice from a general medicine service. J Gen Intern Med. 1998;13(8):568-71. doi: 10.1046/j.1525- 1497.1998.00169.x.

Seaborn Moyse H, Osmun WE. Discharges against medical advice: a community hospital’s experience. Can J Rural Med. 2004;9(3):148-53.

Youssef A. Factors associated with discharge against medical advice in a Saudi teaching hospital. J Taibah Univ Med Sci. 2012;7(1):13-8. doi: 10.1016/j.jtumed.2012.07.006.

Hwang SW, Li J, Gupta R, Chien V, Martin RE. What happens to patients who leave hospital against medical advice? Cmaj. 2003;168(4):417-20.

Al-Hinai SS, Al-Busaidi AS, Al-Busaidi IH. Medical tourism abroad: a new challenge to Oman’s health system-Al Dakhilya region experience. Sultan Qaboos Univ Med J. 2011;11(4):477-84.

Al-Hashar A, Al-Zakwani I. Omanis traveling abroad for healthcare: a time for reflection. Oman Med J. 2018;33(4):271- 2. doi: 10.5001/omj.2018.52.

Asadollah Pour Karimi SH, Mohseni Saravi B, Bagherian Farahabbadi E, Zamanfar D, Fallah M, Asadi Abokheily M. Studying the rate and causes of discharge against medical advice in hospitals affiliated to Mazandaran University of Medical Sciences. Mater Sociomed. 2014;26(3):203-7. doi: 10.5455/msm.2014.26.203-207.

Kishore B. Leave against medical advice: an universal phenomenon. Muller J Med Sci Res. 2013;4(1):1-2. doi: 10.4103/0975-9727.112258.

Lakhotia AN, Sodani A, Dube M, Telang K, Jain R, Athale S. Discharge against medical advice from neurology wards of a teaching hospital: A prospective observational study. Clin Epidemiol Glob Health. 2019;7(1):115-20. doi: 10.1016/j. cegh.2018.02.011.

El Sayed M, Jabbour E, Maatouk A, Bachir R, Dagher GA. Discharge against medical advice from the emergency department: results from a tertiary care hospital in Beirut, Lebanon. Medicine (Baltimore). 2016;95(6):e2788. doi: 10.1097/md.0000000000002788.

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