Purpose
The study explores experiences of lung cancer patients during COVID-19 and considers how changes to care delivery and personal lives affected patient needs.
Methods
Semi-structured telephone interviews were conducted to explore experiences of lung cancer patients during COVID-19. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Interview participants were purposively selected based on age, gender, treatment status, timing of diagnosis (pre/post first COVID-19 lockdown) from a sample of lung cancer patients (any histological subtype/any cancer stage/any point in treatment) who had completed a questionnaire exploring how participants’ lives were impacted by the pandemic and their thoughts on clinical care and remote communication.
Results
Thirty lung cancer patients who participated in the questionnaire study were approached and participated in an interview. Three themes were identified: (1) Adapting to new modes of communication (focusing on experiences of remote communication); (2) Experience of care delivery during the pandemic (describing how all aspects of care delivery had been affected); (3) Impact of the COVID-19 pandemic on quality of life (QOL) (focus on the psychological impact and feeling of reduced support). Themes 1 and 2 are heavily interlinked and both had bearing on patients’ QOL experience.
Conclusion
Lung cancer patients were impacted psychologically by changes to care delivery and changes in their personal life. The findings highlight some benefits to remote consultations but the stage of the treatment pathway and illness trajectory should be considered when determining if this is appropriate. Participants felt support from peers, family and friends was limited during the pandemic.
Background: Cancer patients with Covid-19 causing less severe illness have been safely managed in an outpatient setting but they remain at risk of clinical deterioration. In this pilot study we assessed the feasibility of using wearable biosensors to monitor key physiological data in ambulatory, home based, cancer patients with Covid-19 infection. Two key components of feasibility were assessed: patient acceptability of the devices, and the reliability of transmitting the data in real-time to the treating hospital.
Methods: Ambulatory cancer patients with Covid-19 consented to wearing sensors monitoring heart rate, respiratory rate, and temperature, along with twice daily pulse oximetry measurements for up to three weeks. All physiologic data were transmitted from home to the treating hospital via a secure cellular data pathway. Data other than oxygen saturations was analysed retrospectively. Questionnaires and semi-structured interviews were completed by patients and thematic qualitative analysis performed.
Results: 8 patients (6 female, 2 male) with a median age of 62 years (range 40-73) were recruited. 2 patients completed 21 days on study. 2 patients were admitted to hospital due to decreased oxygen levels. 4 patients discontinued monitoring during the study period. Most participants liked the concept of active monitoring and felt confident about connecting the device and changing the sensors. Others found using the system more challenging. Data transmission was considered good or satisfactory in 5 participants.
Conclusions: This is the first study demonstrating the use of wearable sensors to monitor cancer patients at home with real-time transmission of data to the treating hospital. Participants were generally supportive of remote monitoring and most found the technology easy to use but some issues with usability were highlighted.
Registration:, The study was registered with Clinical Trials.gov on 21/05/2020, registration number: NCT04397705, https://clinicaltrials.gov/ct2/show/NCT04397705
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