On account of the severity of their symptoms, all 20 patients requested or demanded therapy; consequently, there were no therapy refusals.
Exclusion criteria were: age <18 years old, pregnancy and lactation, chronic disorder of calcium or phosphate homeostasis, major hemodynamic instability, use of diuretics in the 24 h before inclusion, anuria or renal replacement therapy and refusal to participate.
My son has a mother on a cocktail of medication, therapy and a refusal to answer the front door half the time.
A possible reason for this non-significant result may be the study power, as our initial sample size calculation did not allow for 25% of participants to refuse consideration of larval therapy (clinicians estimated 10% refusal rate).
Thus it is common practice to accept a patient's refusal of therapy that medically is considered to be appropriate, and instead provide therapy that is considered to be less adequate, but in accordance with the goals, plans and values of the patient – even in cases where this may lead to increased public costs.
Reasons for this were no participation in the initial screening, not showing up for medical evaluation of positive tests, but also noncompliance of physicians in following treatment recommendations leading to noncompliance or refusal of therapy among individuals diagnosed with LTBI.
9 patients did not complete therapy because of: treatment refusal (n= 1), cardiac toxicity (n= 1), early death during FEC chemotherapy (n= 1), major protocol violations (n= 4), hypersensitivity reaction (n= 1) and early death during paclitaxel chemotherapy (n= 1).
They had to have previously received, with unsuccessful results, an anthracycline and a taxane in any combination for the treatment of breast cancer, unless ineligible for these treatments owing to comorbidities or refusal of therapy.
A maximum of 12 cycles of therapy were permitted unless patient refusal, unacceptable toxicity, or disease progression occurred.
Premature withdrawal was defined as initiation of renal replacement therapy, blood transfusion, non-adherence (refusal to take study medication) or withdrawal of consent.
