Abstract S06-01: Changes implemented by U.S. oncology practices in response to COVID-19 pandemic: Initial report from the ASCO Registry on COVID-19 and cancer

Abstract

Background: In April 2020, ASCO initiated a registry to capture and analyze status and outcomes of patients with cancer and COVID-19, and to describe effects of the pandemic on U.S. cancer practices. Initial findings of changes to care delivery are included. Methods: Practices provide data on changes to care delivery due to COVID-19 and longitudinal data on patients with cancer and confirmed COVID-19. At present, 26 cancer practices have enrolled in the Registry—5 academic, 15 hospital/health-system (H/HS) owned, and 6 physician-owned (P-O) located in 19 states. Enrollment of practices and data collection is ongoing. Results: Twenty sites, from 17 practices (3 academic, 9 H/HS owned, and 5 P-O in 15 states) responded (April 20-June 4). All incorporated telemedicine visits; 90% reported use of telemedicine was new. 30% reported “declining some but not all” new patient requests. For patients with cancer not on active therapy, 15% of sites postponed some routine visits, 35% conducted virtually all routine visits by telemedicine, and 50% used telemedicine for some routine visits. Most sites (95%) reported following clinical guidelines for visit postponement; 90% reported following local health authorities on when to resume routine visits. 90% screened patients prior to in-office visits for COVID-19 symptoms by phone and at clinic entrance; 10% screened patients using only one method. 30% modified intravenous (IV) drug infusions, including halting some or all (10%), shortening some or all (20%), or switching from IV to oral drugs (15%). While no sites conducted home-based, anticancer drug infusions, 30% are considering this option if COVID19 conditions change. Most sites modified laboratory specimen collection, including allowing a collection site closer to home (60%) and collection in a patient’s home (1 site). Two sites only allowed patients on oral anticancer drugs to use alternate collection sites. Only 1 site reported specimen collection in patients’ homes. All reported making the following changes to clinic arrangements: requiring use of masks, eliminating accompaniment by a support person (with exceptions), and reducing the visit numbers or increasing time between visits. No sites reported shortages of anticancer or supportive care drugs. 45% experienced shortages of nasopharyngeal swabs, 45% of medical hand sanitizer, and 75% of personal protective equipment. 40% of sites have experienced staffing reductions or changes due to reduced patient visits (30%), transfer to other clinical areas (20%), availability (15%), and COVID-19 illness (15%). Conclusions: The COVID-19 pandemic has had a substantial impact on most aspects of cancer care delivery in U.S. oncology practices. All practices incorporated telemedicine, which is new to most. Adjustments were made to patient visits and scheduled IV drug infusions. Sites reported shortages of equipment related to COVID-19, not cancer or supportive care drug shortages. At the time of the AACR meeting we expect to have data from more practices. Citation Format: Suanna S. Bruinooge, Elizabeth Garrett-Mayer, Stephen Meersman, Patricia Hurley, Brian Bourbeau, Allyn Moushey, Sybil Green, Deborah Kamin, Stephen Grubbs, Richard L. Schilsky. Changes implemented by U.S. oncology practices in response to COVID-19 pandemic: Initial report from the ASCO Registry on COVID-19 and cancer [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S06-01.