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 Electronic Patient Reported Outcomes (ePROs) are commonly used in oncology clinical practice and have shown benefits for patients and health resource use. This review and meta-analysis examined effectiveness of ePROs compared to usual care for health-related outcomes in people with cancer. OBJECTIVE To compare the single effect of administering ePROs to patients with cancer versus a control condition. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Randomised controlled trials evaluating ePRO interventions, improving health-related outcomes, among cancer patients were included. Primary outcome: health-related quality of life (HRQOL). Secondary outcomes: symptoms, hospital admissions, unplanned visits, chemotherapy completion, survival, and satisfaction with care. Effect size of ePROs on health-related outcomes were analysed as standardised mean differences with 95% confidence intervals using the random effects model. RESULTS The search identified 10965 papers. Nineteen papers from 15 studies were included. Meta-analysis showed an improvement in HRQOL at three months, measured by the Functional Assessment of Cancer Therapy- General (FACT-G) (SMD: 0.28 95% CI: -1.22 to 1.78), and at six months with various HRQOL measures (SMD: 0.07 95% CI: -1.24 to 1.39). Results should be interpreted with caution given the wide confidence intervals. Nine studies reported a positive signal on HRQOL with six including tailored patient advice and six using clinician alert systems. CONCLUSIONS Meta-analysis showed a potential improvement in HRQOL at six months and in FACT-G scores at three months for studies that included tailored advice and clinician alerts suggesting these elements may improve ePRO effectiveness. Findings will provide guidance for future use and help healthcare professionals choose the most suitable ePRO features for their patients.
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