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Colomer-Lahiguera S, Canella C, Giacomini S, Van KL, Pedrazzani C, Naegele M, Thouvenin L, O'Meara Stern A, Condorelli R, Corbière T, Witt CM, Eicher M, Ribi K. Patient-reported experiences of cancer care related to the COVID-19 pandemic in Switzerland. Support Care Cancer 2023; 31:410. [PMID: 37347278 DOI: 10.1007/s00520-023-07871-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 06/07/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE This study aims to describe the experience of Swiss oncological patients during the COVID-19 pandemic. METHODS A national multi-center study including five hospitals covering the three main language regions of Switzerland was conducted between March and July 2021. Patients with melanoma, breast, lung, or colon cancer receiving active systemic anti-cancer treatment at the time of the COVID-19 pandemic were included. We conducted semi-structured telephone or onsite interviews alongside the administration of distress and resilience-validated questionnaires. Thematic analysis was performed for the qualitative data and descriptive statistics for the quantitative data. RESULTS Sixty-two cancer patients with a mean age of 61 (SD=14) (58% female) were interviewed. Based on the interviews, we identified that the experience of having cancer during the COVID-19 pandemic was related to five dimensions: psychological, social, support, healthcare, and vaccination. Three themes transverse the five dimensions: (a) needs, (b) positive changes, and (c) phases of the pandemic. In general, patients did not experience delays or disruptions in their cancer treatment nor felt additionally burdened by the pandemic. Lockdown and isolation were reported as mixed experiences (positive and negative), and access to vaccination reassured patients against the risk of infection and instilled hope to return to normalcy. Additionally, we found low distress levels (M=2.9; SD=2.5) and high resilience scores (M=7; SD=1.3) in these patients. CONCLUSION Swiss patients with cancer did not express major needs or disruptions in their care during this period of the COVID-19 pandemic. Results identify the mixed experiences of patients and highlight the high resilience levels.
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Affiliation(s)
- Sara Colomer-Lahiguera
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland.
| | - Claudia Canella
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zürich, Switzerland
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Stellio Giacomini
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland
| | - Kim Lê Van
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland
| | - Carla Pedrazzani
- Department of Economics, Health and Social Sciences, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Matthias Naegele
- Cantonal Hospital St. Gallen, Department of Development and Quality Management in Nursing, Network Oncology, St. Gallen, Switzerland
- Comprehensive Cancer Center Zurich, University Hospital Zurich, Zürich, Switzerland
| | - Laure Thouvenin
- Department of Oncology, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Alix O'Meara Stern
- Department of Medical Oncology, Réseau Hospitalier Neuchatelois, Neuchâtel, Switzerland
| | - Rosaria Condorelli
- Department of Medical Oncology, EOC - Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland
| | - Tourane Corbière
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zürich, Switzerland
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Manuela Eicher
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland
| | - Karin Ribi
- Department Health, Kalaidos University of Applied Sciences, Zürich, Switzerland
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2
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Piras A, Venuti V, D’Aviero A, Cusumano D, Pergolizzi S, Daidone A, Boldrini L. Covid-19 and radiotherapy: a systematic review after 2 years of pandemic. Clin Transl Imaging 2022; 10:611-630. [PMID: 35910079 PMCID: PMC9308500 DOI: 10.1007/s40336-022-00513-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/12/2022] [Indexed: 02/08/2023]
Abstract
Introduction Following the Covid-19 pandemic spread, changes in clinical practice were necessary to limit the pandemic diffusion. Also, oncological practice has undergone changes with radiotherapy (RT) treatments playing a key role.Although several experiences have been published, the aim of this review is to summarize the current evidence after 2 years of pandemic to provide useful conclusions for clinicians. Methods A Pubmed/MEDLINE and Embase systematic review was conducted. The search strategy was "Covid AND Radiotherapy" and only original articles in the English language were considered. Results A total of 2.733 papers were obtained using the mentioned search strategy. After the complete selection process, a total of 281 papers were considered eligible for the analysis of the results. Discussion RT has played a key role in Covid-19 pandemic as it has proved more resilient than surgery and chemotherapy. The impact of the accelerated use of hypofractionated RT and telemedicine will make these strategies central also in the post-pandemic period.
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Affiliation(s)
- Antonio Piras
- Radioterapia Oncologica, Villa Santa Teresa, Palermo, Italy
| | - Valeria Venuti
- Radioterapia Oncologica, Università degli Studi di Palermo, Palermo, Italy
| | - Andrea D’Aviero
- Radiation Oncology, Mater Olbia Hospital, Olbia, Sassari Italy
| | | | - Stefano Pergolizzi
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | - Luca Boldrini
- Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, UOC Radioterapia Oncologica - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
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3
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Carvalho AS, Brito Fernandes Ó, de Lange M, Lingsma H, Klazinga N, Kringos D. Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a scoping review. BMC Health Serv Res 2022; 22:786. [PMID: 35715795 PMCID: PMC9204363 DOI: 10.1186/s12913-022-08166-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/06/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cancer comprises a high burden on health systems. Performance indicators monitoring cancer outcomes are routinely used in OECD countries. However, the development of process and cancer-pathway based information is essential to guide health care delivery, allowing for better monitoring of changes in the quality of care provided. Assessing the changes in the quality of cancer care during the COVID-19 pandemic requires a structured approach considering the high volume of publications. This study aims to summarize performance indicators used in the literature to evaluate the impact of the COVID-19 pandemic on cancer care (January-June 2020) in OECD countries and to assess changes in the quality of care as reported via selected indicators. METHODS Search conducted in MEDLINE and Embase databases. Performance indicators and their trends were collated according to the cancer care pathway. RESULTS This study included 135 articles, from which 1013 indicators were retrieved. Indicators assessing the diagnostic process showed a decreasing trend: from 33 indicators reporting on screening, 30 (91%) signalled a decrease during the pandemic (n = 30 indicators, 91%). A reduction was also observed in the number of diagnostic procedures (n = 64, 58%) and diagnoses (n = 130, 89%). The proportion of diagnoses in the emergency setting and waiting times showed increasing trends (n = 8, 89% and n = 14, 56%, respectively). A decreasing trend in the proportion of earliest stage cancers was reported by 63% of indicators (n = 9), and 70% (n = 43) of indicators showed an increasing trend in the proportion of advanced-stage cancers. Indicators reflecting the treatment process signalled a reduction in the number of procedures: 79%(n = 82) of indicators concerning surgeries, 72%(n = 41) of indicators assessing radiotherapy, and 93%(n = 40) of indicators related to systemic therapies. Modifications in cancer treatment were frequently reported: 64%(n = 195) of indicators revealed changes in treatment. CONCLUSIONS This study provides a summary of performance indicators used in the literature to assess the cancer care pathway from January 2020 to June 2020 in OECD countries, and the changes in the quality of care signalled by these indicators. The trends reported inform on potential bottlenecks of the cancer care pathway. Monitoring this information closely could contribute to identifying moments for intervention during crises.
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Affiliation(s)
- Ana Sofia Carvalho
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands.
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Óscar Brito Fernandes
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Mats de Lange
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
| | - Hester Lingsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Niek Klazinga
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Dionne Kringos
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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4
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Negm AM, Salopek A, Zaide M, Meng VJ, Prada C, Chang Y, Zanwar P, Santos FH, Philippou E, Rosario ER, Faieta J, Falvey JR, Kumar A, Reistetter TA, Dal Bello-Haas V, Bean JF, Bhandari M, Heyn PC. Rehabilitation Care at the Time of Coronavirus Disease-19 (COVID-19) Pandemic: A Scoping Review of Health System Recommendations. Front Aging Neurosci 2022; 13:781271. [PMID: 35058770 PMCID: PMC8764235 DOI: 10.3389/fnagi.2021.781271] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/29/2021] [Indexed: 12/13/2022] Open
Abstract
Purpose: The coronavirus disease-19 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. COVID-19, caused by SARS-CoV-2 has imposed a significant burden on health care systems, economies, and social systems in many countries around the world. The provision of rehabilitation services for persons with active COVID-19 infection poses challenges to maintaining a safe environment for patients and treating providers. Materials and Methods: Established frameworks were used to guide the scoping review methodology. Medline, Embase, Pubmed, CINAHL databases from inception to August 1, 2020, and prominent rehabilitation organizations' websites were searched. Study Selection: We included articles and reports if they were focused on rehabilitation related recommendations for COVID-19 patients, treating providers, or the general population. Data Extraction: Pairs of team members used a pre-tested data abstraction form to extract data from included full-text articles. The strength and the quality of the extracted recommendations were evaluated by two reviewers using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results: We retrieved 6,468 citations, of which 2,086 were eligible for review, after duplicates were removed. We excluded 1,980 citations based on title and abstract screening. Of the screened full-text articles, we included all 106 studies. A summary of recommendations is presented. We assessed the overall evidence to be strong and of fair quality. Conclusion: The rehabilitation setting, and processes, logistics, and patient and healthcare provider precaution recommendations identified aim to reduce the spread of SARS-CoV-2 infection and ensure adequate and safe rehabilitation services, whether face-to-face or through teleservices. The COVID-19 pandemic is rapidly changing. Further updates will be needed over time in order to incorporate emerging best evidence into rehabilitation guidelines.
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Affiliation(s)
- Ahmed M. Negm
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Adrian Salopek
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Mashal Zaide
- Faculty of Sciences, McMaster University, Hamilton, ON, Canada
| | - Victoria J. Meng
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Carlos Prada
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | | | - Preeti Zanwar
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, United States
- NIA Funded U.S. Network on Life Course and Health Dynamics and Disparities in the 21st Century America, University of Southern California, Los Angeles, CA, United States
| | - Flavia H. Santos
- University College Dublin (UCD), Centre for Disability Studies, School of Psychology, University College Dublin, Dublin, Ireland
| | - Elena Philippou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
- Department of Nutritional Sciences, King’s College London, London, United Kingdom
| | - Emily R. Rosario
- Casa Colina Hospital and Centers for Healthcare, Pomona, CA, United States
| | - Julie Faieta
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jason R. Falvey
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Amit Kumar
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
| | - Timothy A. Reistetter
- Department of Occupational Therapy, School of Health Professions, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | | | - Jonathan F. Bean
- New England Geriatric, Research, Department of PM&R, Harvard Medical School, Education and Clinical Center, VA Boston Healthcare System, Boston, MA, United States
- Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Mohit Bhandari
- Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Patricia C. Heyn
- Marymount Center for Optimal Aging, School of Health Sciences, Marymount University, Arlington, VA, United States
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5
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Dinkel A, Goerling U, Hönig K, Karger A, Maatouk I, Petermann-Meyer A, Senf B, Woellert K, Wünsch A, Zimmermann T, Schulz-Kindermann F. Psychooncological care for patients with cancer during 12 months of the Covid-19 pandemic: Views and experiences of senior psychooncologists at German Comprehensive Cancer Centers. Psychooncology 2021; 30:1982-1985. [PMID: 34184361 PMCID: PMC8420502 DOI: 10.1002/pon.5759] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/17/2021] [Accepted: 06/25/2021] [Indexed: 12/03/2022]
Abstract
A monthly videoconference was maintained over 1 year, allowing senior psychooncologists from German Comprehensive Cancer Centers to discuss the implications of the Covid‐19 pandemic for psychooncological care. In the early phase of the pandemic, a widespread disruption of psychooncological services was noted. Rapidly developed adaptations of regular services worked well and sometimes brought about unexpected, creative solutions. In March 2021, the high numbers of infections, the occurrence of new variants of the coronavirus, and the slow progress in vaccination raise fears about new disruptions and restrictions in service provision. In coping with the pandemic, many therapists have felt like many cancer patients do feel in the process of coping with cancer, and this might help to better understand our patients.
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Affiliation(s)
- Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Ute Goerling
- Charité Comprehensive Cancer Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Klaus Hönig
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany.,Comprehensive Cancer Center Ulm, University Ulm Medical Center, Ulm, Germany
| | - André Karger
- Center of Integrated Oncology, University Hospital Duesseldorf, Duesseldorf, Germany.,Clinical Institute of Psychosomatic Medicine and Psychotherapy, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Imad Maatouk
- Psycho-oncology Service, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany.,Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Andrea Petermann-Meyer
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Section Psychooncology, Center for Integrated Oncology - Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Bianca Senf
- Department of Psycho-Oncology, University Cancer Center, Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Katharina Woellert
- Institute for History and Ethics of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Wünsch
- Psychosocial Counselling for Cancer Outpatients, Comprehensive Cancer Center, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Frank Schulz-Kindermann
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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6
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Das IJ, Kalapurakal JA, Strauss JB, Zawislak BR, Gopalakrishnan M, Bajaj A, Mittal BB. Adaptability and Resilience of Academic Radiation Oncology Personnel and Procedures during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5095. [PMID: 34065801 PMCID: PMC8151822 DOI: 10.3390/ijerph18105095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/03/2021] [Accepted: 05/10/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND A comprehensive response to the unprecedented SARS-CoV-2 (COVID-19) challenges for public health and its impact on radiation oncology patients and personnel for resilience and adaptability is presented. METHODS The general recommendations included working remotely when feasible, implementation of screening/safety and personal protective equipment (PPE) guidelines, social distancing, regular cleaning of treatment environment, and testing for high-risk patients/procedures. All teaching conferences, tumor boards, and weekly chart rounds were conducted using a virtual platform. Additionally, specific recommendations were given to each section to ensure proper patient treatments. The impact of these measures, especially adaptability and resilience, were evaluated through specific questionnaire surveys. RESULTS These comprehensive COVID-19-related measures resulted in most staff expressing a consistent level of satisfaction in regard to personal safety, maintaining a safe work environment, continuing quality patient care, and continuing educational activities during the pandemic. There was a significant reduction in patient treatments and on-site patient visits with an appreciable increase in the number of telemedicine e-visits. CONCLUSIONS Survey results demonstrated substantial adaptability and resilience, including in the rapid recovery of departmental activities during the reactivation phase. In the event of a future public health emergency, the measures implemented may be adopted with good outcomes by radiation oncology departments across the globe.
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Affiliation(s)
- Indra J. Das
- Department of Radiation Oncology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 251 East Huron Street, Galter Pavilion, LC-178, Chicago, IL 60611, USA; (J.A.K.); (J.B.S.); (B.R.Z.); (M.G.); (A.B.); (B.B.M.)
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7
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Impact of COVID-19 pandemic on the oncologic care continuum: urgent need to restore patients care to pre-COVID-19 era. JOURNAL OF RADIOTHERAPY IN PRACTICE 2021. [PMCID: PMC8060543 DOI: 10.1017/s1460396921000303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract
Background:
Globally, cancer is the second leading cause of death, and it is estimated that over 18·1 million new cases are diagnosed annually. The COVID-19 pandemic has significantly impacted almost every aspect of the provision and management of cancer care worldwide. The time-critical nature of COVID-19 diagnosis and the large number of patients requiring hospitalisation necessitated the rerouting of already limited resources available for cancer services and programmes to the care of COVID-19 patients. Furthermore, the stringent social distancing, restricted in-hospital visits and lockdown measures instituted by various governments resulted in the disruption of the oncologic continuum including screening, diagnostic and prevention programmes, treatments and follow-up services as well as research and clinical trial programmes.
Materials and Methods:
We searched several databases from October 2020 to January 2021 for relevant studies published in English between 2020 and 2021 and reporting on the impact of COVID-19 on the cancer care continuum. This narrative review paper describes the impact of the COVID-19 pandemic on the cancer patient care continuum from screening and prevention to treatments and ongoing management of patients.
Conclusions:
The COVID-19 pandemic has profoundly impacted cancer care and the management of cancer services and patients. Nevertheless, the oncology healthcare communities worldwide have done phenomenal work with joint and collaborative efforts, utilising best available evidence-based guidelines to continue to give safe and effective treatments for cancer patients while maintaining the safety of patients, healthcare professionals and the general population. Nevertheless, several healthcare centres are now faced with significant challenges with the management of the backlog of screening, diagnosis and treatment cases. It is imperative that governments, leaders of healthcare centres and healthcare professionals take all necessary actions and policies focused on minimising further system-level delays to cancer screening, diagnosis, treatment initiation and clearing of all backlogs cases from the COVID-19 pandemic in order to mitigate the negative impact on cancer outcomes.
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8
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Riera R, Bagattini ÂM, Pacheco RL, Pachito DV, Roitberg F, Ilbawi A. Delays and Disruptions in Cancer Health Care Due to COVID-19 Pandemic: Systematic Review. JCO Glob Oncol 2021; 7:311-323. [PMID: 33617304 PMCID: PMC8081532 DOI: 10.1200/go.20.00639] [Citation(s) in RCA: 256] [Impact Index Per Article: 85.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
PURPOSE There has been noteworthy concern about the impact of COVID-19 pandemic on health services including the management of cancer. In addition to being considered at higher risk for worse outcomes from COVID-19, people with cancer may also experience disruptions or delays in health services. This systematic review aimed to identify the delays and disruptions to cancer services globally. METHODS This is a systematic review with a comprehensive search including specific and general databases. We considered any observational longitudinal and cross-sectional study design. The selection, data extraction, and methodological assessment were performed by two independent reviewers. The methodological quality of the studies was assessed by specific tools. The delays and disruptions identified were categorized, and their frequency was presented. RESULTS Among the 62 studies identified, none exhibited high methodological quality. The most frequent determinants for disruptions were provider- or system-related, mainly because of the reduction in service availability. The studies identified 38 different categories of delays and disruptions with impact on treatment, diagnosis, or general health service. Delays or disruptions most investigated included reduction in routine activity of cancer services and number of cancer surgeries; delay in radiotherapy; and delay, reschedule, or cancellation of outpatient visits. Interruptions and disruptions largely affected facilities (up to 77.5%), supply chain (up to 79%), and personnel availability (up to 60%). CONCLUSION The remarkable frequency of delays and disruptions in health care mostly related to the reduction of the COVID-19 burden unintentionally posed a major risk on cancer care worldwide. Strategies can be proposed not only to mitigate the main delays and disruptions but also to standardize their measurement and reporting. As a high number of publications continuously are being published, it is critical to harmonize the upcoming reports and constantly update this review.
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Affiliation(s)
- Rachel Riera
- Centre of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, Brazil.,Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.,Oxford-Brazil EBM Alliance, Petrópolis, Brazil
| | | | - Rafael Leite Pacheco
- Centre of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, Brazil.,Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.,Oxford-Brazil EBM Alliance, Petrópolis, Brazil.,Centro Universitário São Camilo, São Paulo, Brazil
| | | | - Felipe Roitberg
- Instituto do Câncer do Estado de São Paulo/HCFMUSP, São Paulo, Brazil.,Department of Noncommunicable Diseases, World Health Organization (WHO), Geneva, Switzerland.,European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - Andre Ilbawi
- Department of Noncommunicable Diseases, World Health Organization (WHO), Geneva, Switzerland
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9
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Mallick I, Chakraborty S, Baral S, Saha S, Lal VH, Sasidharan R, Santosham RJM, Chhatbar S, Bhusal S, Goyal L, Maulik S, Phesao V, Arora S, Bhattacharyya T, Mahata A, Prasath S, Balakrishnan A, Mandal S, Arunsingh MA, Achari R, Chatterjee S. Prioritizing Delivery of Cancer Treatment During a COVID-19 Lockdown: The Experience of a Clinical Oncology Service in India. JCO Glob Oncol 2021; 7:99-107. [PMID: 33449800 PMCID: PMC8081517 DOI: 10.1200/go.20.00433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE A COVID-19 lockdown in India posed significant challenges to the continuation of radiotherapy (RT) and systemic therapy services. Although several COVID-19 service guidelines have been promulgated, implementation data are yet unavailable. We performed a comprehensive audit of the implementation of services in a clinical oncology department. METHODS A departmental protocol of priority-based treatment guidance was developed, and a departmental staff rotation policy was implemented. Data were collected for the period of lockdown on outpatient visits, starting, and delivery of RT and systemic therapy. Adherence to protocol was audited, and factors affecting change from pre-COVID standards analyzed by multivariate logistic regression. RESULTS Outpatient consults dropped by 58%. Planned RT starts were implemented in 90%, 100%, 92%, 90%, and 75% of priority level 1-5 patients. Although 17% had a deferred start, the median time to start of adjuvant RT and overall treatment times were maintained. Concurrent chemotherapy was administered in 89% of those eligible. Systemic therapy was administered to 84.5% of planned patients. However, 33% and 57% of curative and palliative patients had modifications in cycle duration or deferrals. The patient’s inability to come was the most common reason for RT or ST deviation. Factors independently associated with a change from pre-COVID practice was priority-level allocation for RT and age and palliative intent for systemic therapy. CONCLUSION Despite significant access limitations, a planned priority-based system of delivery of treatment could be implemented.
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Affiliation(s)
- Indranil Mallick
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | | | - Shweta Baral
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Saheli Saha
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Vishnu H Lal
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Rohit Sasidharan
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | | | - Samarth Chhatbar
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Subecha Bhusal
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Love Goyal
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Shaurav Maulik
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Vezokhoto Phesao
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Siddharth Arora
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | | | - Anurupa Mahata
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Sriram Prasath
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Arun Balakrishnan
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Samar Mandal
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Moses A Arunsingh
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Rimpa Achari
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Sanjoy Chatterjee
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
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10
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Chaudhari S, Sharma SD, Shrivastava SK. Revision in Standard Operating Procedures of Radiation Oncology Department and Quality Assurance Schedule under COVID-19 Pandemic. J Med Phys 2020; 45:130-133. [PMID: 32831496 PMCID: PMC7416866 DOI: 10.4103/jmp.jmp_37_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 05/23/2020] [Accepted: 06/06/2020] [Indexed: 01/24/2023] Open
Affiliation(s)
- Suresh Chaudhari
- Department of Radiation Oncology, Apollo Hospitals, Navi Mumbai, Maharashtra, India
| | - Sunil Dutt Sharma
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
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