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Al‐Rikaby A, Sulaiman A, Thompson JR, Saw RPM, Boyle F, Taylor N, Carlino MS, Morton RL, Nieweg OE, Thompson JF, Bartula I. Telehealth follow-up consultations for melanoma patients during the COVID-19 pandemic: Patient and clinician satisfaction. Cancer Med 2023; 12:21373-21388. [PMID: 37930181 PMCID: PMC10726917 DOI: 10.1002/cam4.6679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/05/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic caused rapid implementation of telehealth for melanoma follow-up care in Australia. This study explores Australian melanoma patients and clinicians' level of satisfaction with telehealth. METHODS A cross-sectional study was conducted across three specialist melanoma centres in Sydney, Australia. Melanoma patients (all stages) and clinicians completed mixed methods surveys seeking socio-demographic and clinical information and questionnaires to assess satisfaction with telehealth. Additionally, patients completed measures of quality of life, fear of cancer recurrence and trust in their oncologist. Patients and clinicians provided open-ended responses to qualitative questions about their perceptions of telehealth. RESULTS One hundred and fifteen patients and 13 clinicians responded to surveys. Telephone was used by 109 (95%) patients and 11 (85%) clinicians. Fifty-seven (50%) patients and nine (69%) clinicians preferred face-to-face consultations, 38 (33%) patients and 3 (23%) clinicians preferred a combination of face-to-face and telehealth consultations. Five (4%) patients and nil clinicians preferred telehealth consultations. Patients diagnosed with early-stage melanoma, using telehealth for the first time, who have lower trust in their oncologist, and having higher care delivery, communication and supportive care concerns were likely to report lower satisfaction with telehealth. Open-ended responses were consistent between patients and clinicians, who reported safety, convenience and improved access to care as major benefits, while identifying personal, interpersonal, clinical and system-related disadvantages. DISCUSSION While telehealth has been widely implemented during COVID-19, the benefits identified by patients and clinicians may extend past the pandemic. Telehealth may be considered for use in conjunction with face-to-face consultations to provide melanoma follow-up care.
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Affiliation(s)
- Ali Al‐Rikaby
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Ahmad Sulaiman
- Melanoma Institute AustraliaThe University of SydneyNorth SydneyNew South WalesAustralia
| | - Jake R. Thompson
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Melanoma Institute AustraliaThe University of SydneyNorth SydneyNew South WalesAustralia
| | - Robyn P. M. Saw
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Melanoma Institute AustraliaThe University of SydneyNorth SydneyNew South WalesAustralia
- Department of Melanoma and Surgical OncologyRoyal Prince Alfred HospitalSydneyNew South WalesAustralia
| | - Frances Boyle
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Melanoma Institute AustraliaThe University of SydneyNorth SydneyNew South WalesAustralia
- Patricia Ritchie Centre for Cancer Care and ResearchMater HospitalNorth SydneyNew South WalesAustralia
| | - Nicole Taylor
- Department of Medical OncologyWestmead and Blacktown HospitalsSydneyNew South WalesAustralia
| | - Matteo S. Carlino
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Melanoma Institute AustraliaThe University of SydneyNorth SydneyNew South WalesAustralia
- Department of Medical OncologyWestmead and Blacktown HospitalsSydneyNew South WalesAustralia
| | - Rachael L. Morton
- Melanoma Institute AustraliaThe University of SydneyNorth SydneyNew South WalesAustralia
- NHMRC Clinical Trials Centre, Faculty of Medicine and HealthThe University of SydneyCamperdown, SydneyNew South WalesAustralia
| | - Omgo E. Nieweg
- Melanoma Institute AustraliaThe University of SydneyNorth SydneyNew South WalesAustralia
- Department of Melanoma and Surgical OncologyRoyal Prince Alfred HospitalSydneyNew South WalesAustralia
| | - John F. Thompson
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Melanoma Institute AustraliaThe University of SydneyNorth SydneyNew South WalesAustralia
- Department of Melanoma and Surgical OncologyRoyal Prince Alfred HospitalSydneyNew South WalesAustralia
| | - Iris Bartula
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Melanoma Institute AustraliaThe University of SydneyNorth SydneyNew South WalesAustralia
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Kruger D, Samuels N, Lacey J, Keshet Y, Gressel O, Dodiuk-Gad RP, Shulman K, Tapiro Y, Golan M, Ben-Arye E. Exploring a multi-disciplinary model of supportive cancer care for monoclonal antibody treatment-related dermatological symptoms. Support Care Cancer 2023; 31:185. [PMID: 36821054 PMCID: PMC9947431 DOI: 10.1007/s00520-023-07642-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
CONTEXT AND OBJECTIVES The present study examined the perspectives of healthcare providers (HCPs) in designing a multi-disciplinary model of supportive cancer care for the relief of dermatology-related symptoms caused by monoclonal antibody therapies. METHODS The study employed a mixed research methodology, with qualitative research embedded within a pragmatic prospective study of a registry protocol study. Patients undergoing oncology therapy with MoAB, anti-HER2, and anti-PD-L1 monoclonal antibodies were identified among a cohort of patients referred to an integrative oncology (IO) consultation for symptom relief and improved quality of life (QoL). Case studies with significant dermatology-related concerns were selected and presented to a panel of 6 HCPs trained in medical oncology, oncology nursing, family medicine, supportive cancer care, and IO. HCP narratives were qualitatively analyzed and assessed using ATLAS.Ti software for systematic coding. RESULTS Of the 924 patients referred to the IO consultation, 208 were treated with monoclonal antibodies, from which 50 were selected for further evaluation. Of these, 7 cases were presented to the HCP team who were asked to identify treatment gaps requiring a multi-disciplinary approach. Qualitative analysis identified 3 major themes: a biophysical perspective; a psycho-social-spiritual perspective; and the implementation of integrated care. DISCUSSION There is a need for a multi-disciplinary approach when treating patients suffering from monoclonal antibody treatment-related skin toxicities. HCP-reported themes highlight the need to identify patients for whom such an approach is warranted; conditions in which a psycho-social-spiritual perspective should be considered, in addition to a bio-physical approach; and considerations of who should be designated as the patient's primary case manager.
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Affiliation(s)
- Dikla Kruger
- Integrative Oncology Program, Oncology Service; Lin, Carmel, and Zebulon Medical Centers, Clalit Health Services, Haifa, Israel.,Department of Family Medicine, Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel
| | - Noah Samuels
- The Center for Integrative Complementary Medicine, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Judith Lacey
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia.,Clinical School of Medicine, University of Sydney, Camperdown, Australia.,NICM Health Research Institute, Western Sydney University, Sydney, Australia
| | - Yael Keshet
- Department of Sociology and Anthropology, Western Galilee Academic College, Akko, Israel
| | - Orit Gressel
- Integrative Oncology Program, Oncology Service; Lin, Carmel, and Zebulon Medical Centers, Clalit Health Services, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Roni P Dodiuk-Gad
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.,Department of Dermatology, Emek Medical Center, Afula, Israel.,Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Katerina Shulman
- The Oncology Service, Lin and Zebulon Medical Centers, Clalit Health Services, Haifa, Israel.,Carmel Medical Center, Haifa, Israel
| | - Yehudit Tapiro
- The Oncology Service, Lin and Zebulon Medical Centers, Clalit Health Services, Haifa, Israel
| | - Miri Golan
- Integrative Oncology Program, Oncology Service; Lin, Carmel, and Zebulon Medical Centers, Clalit Health Services, Haifa, Israel
| | - Eran Ben-Arye
- Integrative Oncology Program, Oncology Service; Lin, Carmel, and Zebulon Medical Centers, Clalit Health Services, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
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Ungureanu L, Apostu AP, Vesa ȘC, Cășeriu AE, Frățilă S, Iancu G, Bejinariu N, Munteanu M, Șenilă SC, Vasilovici A. Impact of the COVID-19 Pandemic on Melanoma Diagnosis in Romania-Data from Two University Centers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15129. [PMID: 36429847 PMCID: PMC9690697 DOI: 10.3390/ijerph192215129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic affected the healthcare system in our country and led non-COVID patients to postpone medical visits that were not urgent. The purpose of this study was to investigate the impact of the first year of the COVID-19 pandemic on the trends in melanoma diagnosis and to compare the pathological characteristics of melanoma patients before and during the pandemic. The number of primary cutaneous melanomas diagnosed each month between 1 March 2019 and 29 February 2020 (pre-COVID-19) and between 1 March 2020 and 28 February 2021 (COVID-19) in the North-Western Region of Romania (Cluj and Bihor counties) was determined. The pathological characteristics of melanomas diagnosed in the two intervals were compared. The number of melanoma diagnoses substantially decreased during the pandemic, with 66 (-19.3%) fewer cutaneous melanomas being diagnosed in the first year of the pandemic when compared with the previous year. The tumor thickness and mitotic rate were significantly higher in cases found during the COVID-19 pandemic. Our study suggests that COVID-19 has delayed diagnosis in patients with melanoma, leading to the detection of thicker melanomas that may increase morbidity and mortality. Further studies are needed to determine the consequences of this delay on outcomes.
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Affiliation(s)
- Loredana Ungureanu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Adina Patricia Apostu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Ștefan Cristian Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
| | - Alexandra Elena Cășeriu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Simona Frățilă
- Faculty of Medicine and Pharmacy, University of Oradea, 410068 Oradea, Romania
- Clinical Emergency County Hospital, 410039 Oradea, Romania
| | - Gabriela Iancu
- Department of Dermatology, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
- Clinic of Dermatology, County Emergency Hospital Sibiu, 550245 Sibiu, Romania
| | - Nona Bejinariu
- Santomar Oncodiagnostic Laboratory, 400350 Cluj-Napoca, Romania
| | - Maximilian Munteanu
- Department of Plastic and Reconstructive Surgery, “Prof Dr. I. Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
| | - Simona C. Șenilă
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Alina Vasilovici
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
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Caini S, Brusasco M, Niero G, De Giorgi V, Lombardo M, Massone C, Medri M, Palmieri G, Pizzichetta M, Quaglino P, Satta R, Feliciani C, Gandini S, Stanganelli I. Health Care and Safety of Patients with Melanoma during the COVID‐19 Pandemic in Italy. J Eur Acad Dermatol Venereol 2022; 36:e510-e512. [PMID: 35278222 PMCID: PMC9115002 DOI: 10.1111/jdv.18056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S. Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit Institute for Cancer Research, Prevention and Clinical Network (ISPRO) Florence Italy
| | - M. Brusasco
- Section of Dermatology Department of Medicine and Surgery University of Parma Parma Italy
| | - G. Niero
- Italian Association of Melanoma Patients (AIMaMe) Rome Italy
| | - V. De Giorgi
- Department of Dermatology University of Florence Florence Italy
| | - M. Lombardo
- Department of Dermatology Ospedale di Circolo e Fondazione Macchi Varese Italy
| | - C. Massone
- Dermatology Unit Galliera Hospital Genoa Italy
| | - M. Medri
- Skin Cancer Unit Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Meldola FC Italy
| | - G. Palmieri
- Immuno‐Oncology & Cancer Biotherapies University of Sassari ‐ Unit of Cancer Genetics, Institute for Genetic and Biomedical Research – National Research Council (IRGB‐CNR) Sassari Italy
| | - M.A. Pizzichetta
- Dermatologic Clinic University of Trieste Trieste Italy
- Department of Medical Oncology Centro di Riferimento Oncologico di Aviano (CRO), (IRCCS) Aviano Italy
| | - P. Quaglino
- Dermatologic Clinic Department of Medical Sciences University of Turin Medical School Turin Italy
| | - R. Satta
- Department of Surgical Microsurgical and Medical Sciences Unit of Dermatology University of Sassari Sassari Italy
| | - C. Feliciani
- Section of Dermatology Department of Medicine and Surgery University of Parma Parma Italy
| | - S. Gandini
- Division of Epidemiology and Biostatistics European Institute of Oncology Milan Italy
| | - I. Stanganelli
- Section of Dermatology Department of Medicine and Surgery University of Parma Parma Italy
- Italian Association of Melanoma Patients (AIMaMe) Rome Italy
- Department of Dermatology University of Florence Florence Italy
- Department of Dermatology Ospedale di Circolo e Fondazione Macchi Varese Italy
- Dermatology Unit Galliera Hospital Genoa Italy
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