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Zhang S, Wang S, Dong Y, Chen X, Hu M, Kou S, Zhang C, Wu S, Tian Y. Current care practices for patients with Duchenne muscular dystrophy in China. Brain Dev 2022; 44:623-629. [PMID: 35691779 PMCID: PMC9181563 DOI: 10.1016/j.braindev.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/18/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The coronavirus disease (COVID-19) pandemic has presented challenges in the care of patients with chronic diseases. We identified the challenges faced by Chinese patients with Duchenne muscular dystrophy (DMD) during the pandemic. METHODS An online cross-sectional survey was conducted between March 27 and June 30, 2021. RESULTS Of the 2105 valid questionnaire responses, 2,056 patients were from non-lockdown areas. In these areas, 42.8% reduced outside daily activities, 49.4% reduced rehabilitation service use, 39.7% postponed regular follow-ups, and 40.8% reported accelerated motor function decline. These figures generally increased for patients from lockdown areas-67.3% reduced outside daily activities, 44.9% reduced rehabilitation service use, 79.6% postponed regular follow-ups, and 55.1% reported accelerated motor function decline. Ambulation loss was most commonly reported in September and March before 2020; however, this trend was absent in 2020. Regarding the informed prices of disease-modifying drugs in Europe and the United States, 86.7% could afford a maximum of one-twentieth of the prices, 8.0% could afford one-tenth of the prices, and only 0.6% of the patients could afford the full prices. CONCLUSIONS Implementation of standardized care for DMD in China is consistent with global practices, and the COVID-19 pandemic has affected the care of patients with chronic diseases worldwide, particularly in lockdown areas. Telemedicine is an effective model for providing healthcare to such patients. Healthcare workers should assist patients and establish more robust chronic disease management systems. Collaboration between governmental and non-governmental entities could address the cost of disease-modifying drugs in China and other developing countries.
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Affiliation(s)
- Shu Zhang
- Research Center for Birth Defects Prevention and Control Technology, Chinese PLA General Hospital, 28 Fu-Xing Road, Beijing 100853, China,Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Shaoxia Wang
- Department of Neurology, Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - Yuru Dong
- Department of Radiology, Third Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Xinyu Chen
- Department of Neurology, Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - Miao Hu
- Department of Neurology, Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - Sen Kou
- Department of Neurology, Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - Chunyan Zhang
- Research Center for Birth Defects Prevention and Control Technology, Chinese PLA General Hospital, 28 Fu-Xing Road, Beijing 100853, China
| | - Shiwen Wu
- Department of Neurology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Yaping Tian
- Research Center for Birth Defects Prevention and Control Technology, Chinese PLA General Hospital, 28 Fu-Xing Road, Beijing 100853, China.
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Brands M, Verbeek A, Geurts S, Merkx T. Follow-up after oral cancer treatment-Transition to a personalized approach. J Oral Pathol Med 2021; 50:429-434. [PMID: 33270280 DOI: 10.1111/jop.13147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 11/28/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Guidelines for follow-up after oral cancer treatment are not site-specific and encompass the entire head and neck area rather than the oral cavity alone. This one-size-fits-all protocol disregards the differences in aetiology, treatment and differential distribution of new disease between the subsites. With the effectiveness of follow-up in early detection of new disease being put into question, the focus of follow-up programmes might shift to other aspects of survivorship care. Personalization of follow-up is important, considering patient-specific features and needs. Furthermore, the COVID-19 pandemic urges us to rethink our follow-up practice. FINDINGS This paper discusses ways in which routine follow-up in patients treated for oral cancer can be optimized. Patients with a high risk of new disease might benefit from an intensified follow-up regimen, whilst patients with a low risk of new disease, a low chance of cure or limited life expectancy could benefit from a de-intensified follow-up regimen. The latter could include a shorter follow-up period and focus on goals other than early detection of new disease. Education of patients to report new symptoms early is of vital importance as the majority of new disease presents symptomatically. Other health care professionals such as specialist nurses and dentists need to play an important leading role in survivorship care. Remote consultations may be useful to perform more efficient and patient-centred follow-up care. CONCLUSION Routine follow-up needs to be seen as an integrated part of an individualized survivorship plan that is provided by the entire multidisciplinary team.
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Affiliation(s)
- Marieke Brands
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.,Department of Oral and Maxillofacial Surgery, University Hospital Monklands, Airdrie, UK.,Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - André Verbeek
- Department for Health Evidence, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Sandra Geurts
- Department of Medical Oncology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Thijs Merkx
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.,Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
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Aminnudin AN, Doss JG, Ismail SM, Chai MB, Abidin MZ, Basri CSJM, Kipli NP, Wei LC. Can post-treatment oral cancer patients' concerns reflect their cancer characteristics, HRQoL, psychological distress level and satisfaction with consultation? Ecancermedicalscience 2020; 14:1118. [PMID: 33209109 PMCID: PMC7652548 DOI: 10.3332/ecancer.2020.1118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Indexed: 12/30/2022] Open
Abstract
Background Oral cancer and its treatment impact patients' post-treatment outcomes, challenging clinicians to manage them optimally. Addressing patients' concerns is central to holistic patient-centred care. Objectives This study aimed to determine post-treatment oral cancer patients' concerns and its relationship with patients' clinical characteristics, health-related quality of life (HRQoL), psychological distress and patient satisfaction with the follow-up consultation. Methods A total of 85 oral cancer patients were recruited from a three-armed pragmatic RCT study on the patient concerns inventory for head and neck cancer (PCI-H&N), which was conducted at six hospital-based oral maxillofacial specialist clinics throughout Malaysia. Malaysians aged 18 years and above and on follow-ups from 1 month to 5 years or more were eligible. Patients completed the PCI-H&N, functional assessment of cancer therapy -H&N v4.0 and Distress Thermometer at pre-consultation and satisfaction questionnaire at post-consultation. The data were analysed descriptively; multiple linear regression and multivariate logistic regression analyses were used to determine possible predictors of patients' HRQoL and psychological distress. Results 'Recurrence or fear of cancer coming back' (31.8%) was most frequently selected. 43.5% of patients selected ≥4 concerns. A significantly high number of concerns were associated with patients of '1-month to 1-year post-treatment' (n = 84%; p = 0.001). A significant association existed between 'time after treatment completed' and patients' concerns of 'chewing/eating', 'mouth opening', 'swelling', 'weight', 'ability to perform', 'cancer treatment' and 'supplement/diet-related'. 'Chewing/eating' was predicted for low HRQoL (p < 0.0001) followed by 'appearance' and 'ability to perform recreation activities' (personal functions domain). Patients with high psychological distress levels were 14 times more likely to select 'ability to perform recreation activities' and seven times more likely to select 'feeling depressed'. No significant association was identified between patients' concerns and patients' satisfaction with the consultation. Conclusion Routine follow-up consultations should incorporate the PCI-H&N prompt list to enhance patient-centred care approach as the type and number of patients' concerns are shown to reflect their HRQoL and psychological distress.TRIAL REGISTRATION: NMRR-18-3624-45010 (IIR).
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Affiliation(s)
- Ainon Natrah Aminnudin
- Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia.,Oral Health Program, Ministry of Health Malaysia (MOH), 62590 Putrajaya, Malaysia
| | - Jennifer Geraldine Doss
- Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia.,Oral Cancer Research and Coordinating Centre (OCRCC), University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Siti Mazlipah Ismail
- Department of Oro-Maxillofacial Surgical & Medical Sciences, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ma Bee Chai
- Oral Maxillo-Facial Surgery, Sultanah Aminah Hospital, 80100 Johore Bahru, Malaysia
| | - Marzuki Zainal Abidin
- Oral Maxillo-Facial Surgery, Queen Elizabeth Hospital, 88200 Kota Kinabalu, Malaysia
| | | | | | - Lee Chee Wei
- Oral Maxillo-Facial Surgery, Kuala Lumpur General Hospital, 50586 Kuala Lumpur, Malaysia
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Zuliani S, Zampiva I, Tregnago D, Casali M, Cavaliere A, Fumagalli A, Merler S, Riva ST, Rossi A, Zacchi F, Zaninotto E, Auriemma A, Pavarana M, Soldà C, Benini L, Borghesani M, Caldart A, Casalino S, Gaule M, Kadrija D, Mongillo M, Pesoni C, Biondani P, Cingarlini S, Fiorio E, Melisi D, Parolin V, Tondulli L, Belluomini L, Zecchetto C, Avesani B, Biasi A, Bovo C, Dazzani E, Dodi A, Gelmini S, Leta LC, Lo Cascio G, Lombardo F, Lucin E, Martinelli IA, Messineo L, Moscarda V, Pafumi S, Reni A, Sartori G, Scaglione IM, Shoval Y, Sposito M, Tacconelli E, Trestini I, Zambonin V, Zanelli S, Pilotto S, Milella M. Organisational challenges, volumes of oncological activity and patients' perception during the severe acute respiratory syndrome coronavirus 2 epidemic. Eur J Cancer 2020; 135:159-169. [PMID: 32580131 PMCID: PMC7287451 DOI: 10.1016/j.ejca.2020.05.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 05/28/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND On February 23rd, the 1st case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was diagnosed at the University Hospital Trust of Verona, Italy. On March 13th, the Oncology Section was converted into a 22-inpatient bed coronavirus disease (COVID) Unit, and we reshaped our organisation to face the SARS-CoV-2 epidemic, while maintaining oncological activities. METHODS We tracked down (i) volumes of oncological activities (January 1st - March 31st, 2020 versus the same period of 2019), (ii) patients' and caregivers' perception and (iii) SARS-CoV-2 infection rate in oncology health professionals and SARS-CoV-2 infection-related hospital admissions of "active"' oncological patients. RESULTS As compared with the same trimester in 2019, the overall reduction in total numbers of inpatient admissions, chemotherapy administrations and specialist visits in January-March 2020 was 8%, 6% and 3%, respectively; based on the weekly average of daily accesses, reduction in some of the oncological activities became statistically significant from week 11. The overall acceptance of adopted measures, as measured by targeted questionnaires administered to a sample of 241 outpatients, was high (>70%). Overall, 8 of 85 oncology health professionals tested positive for SARS-CoV-2 infection (all but one employed in the COVID Unit, no hospital admissions and no treatment required); among 471 patients admitted for SARS-CoV-2 infection, 7 had an "active"' oncological disease (2 died of infection-related complications). CONCLUSIONS A slight, but statistically significant reduction in oncology activity was registered during the SARS-CoV-2 epidemic peak in Verona, Italy. Organisational and protective measures adopted appear to have contributed to keep infections in both oncological patients and health professionals to a minimum.
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Affiliation(s)
- Serena Zuliani
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Ilaria Zampiva
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Daniela Tregnago
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Miriam Casali
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Alessandro Cavaliere
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Arianna Fumagalli
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Sara Merler
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Silvia Teresa Riva
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Alice Rossi
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Francesca Zacchi
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Elisa Zaninotto
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Alessandra Auriemma
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Michele Pavarana
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Caterina Soldà
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Lavinia Benini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Michele Borghesani
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Alberto Caldart
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Simona Casalino
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Marina Gaule
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Dzenete Kadrija
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Marta Mongillo
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Camilla Pesoni
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Pamela Biondani
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Sara Cingarlini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Elena Fiorio
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Davide Melisi
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Veronica Parolin
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Luca Tondulli
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Lorenzo Belluomini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Camilla Zecchetto
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Barbara Avesani
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Assunta Biasi
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Chiara Bovo
- Medical Direction, Verona University Hospital Trust, Verona, Italy.
| | - Elena Dazzani
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Alessandra Dodi
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Sara Gelmini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Luigi Carmine Leta
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Giuliana Lo Cascio
- Microbiology and Virology Unit, Verona University Hospital Trust, Verona, Italy.
| | - Fiorella Lombardo
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Eleonora Lucin
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Ilaria Asja Martinelli
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Luisa Messineo
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Viola Moscarda
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Sarah Pafumi
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Anna Reni
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Giulia Sartori
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Ilaria Mariangela Scaglione
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Yiftach Shoval
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Marco Sposito
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Evelina Tacconelli
- Section of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Ilaria Trestini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Valentina Zambonin
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Sara Zanelli
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Sara Pilotto
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Michele Milella
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
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