Approaches and best practices for managing cancer pain within the constraints of the COVID-19 pandemic in India

Abstract

Novel corona virus disease 2019 (COVID-19) is an ongoing pandemic that has impacted the entire world. The Indian government has responded strongly and very stringently to the crisis, through a nationwide lockdown. The health-care (HC) systems in the country are striving hard to maintain equitable care across illness spectra, while responding the emergencies imposed by the COVID-19 crisis. Under these circumstances, guidelines for managing several diseases including that for cancer care have been modified. As modified guidelines for cancer care have their focus on disease management, cancer pain management and maintaining continuity of care for patients with advanced progressive disease have taken a backseat in the available cancer care guidelines. This article describes the challenges, approaches to solutions with evidence-based practices that can be utilized to ensure competent management of cancer pain during the COVID-19 pandemic in India. It provides an overview of adapting to telehealth consultations for identification, evaluation and management of cancer pain, safe and rational use of analgesics and adjuvant drugs, recognizing and responding to holistic care needs and addressing the total pain, ensuring continuity of pain management, and strategies when complying with narcotic drug regulations, while ensuring safety of patients and HC providers.

Lessons for Vietnam on the Use of Digital Technologies to Support Patient-Centered Care in Low- and Middle-Income Countries in the Asia-Pacific Region: Scoping Review

“…According to a narrative review, the use of teleconsultations coupled with services such as teleradiology and telepathology may enable patients to receive advice and diagnoses in a shorter time period and without the need for referral to specialists, thereby freeing up specialist availability while also providing patients with faster access to the care they need [ 65 ]. Third and last, DHTs enabled patients to be triaged to a care mode that best suited their needs and preferences [ 38 , 50 , 62 , 65 , 70 ]. As in the case of remote monitoring, this enabled some patients to receive remote care rather than receiving face-to-face care and thereby contributed to both meeting patient preferences and the conservation of clinic and hospital resources.…”

“…Regarding the user level, the availability of technical support and user education and training with regard to DHTs was the most commonly reported enabler [31,41,50,54,60,62,65,66,68], whereas low literacy and technical literacy emerged as a user-level barrier in several of the publications (9/45, 20%) [38,40,44,46,47,54,65,66,69]. Finally, at a broader environmental level, governance that ensures security, privacy, and integrity of DHTs [32,[65][66][67]71,73,74] as well as cross-sectorial collaboration between and within government and nongovernment sectors on development, implementation, and promotion of DHTs [62,64,66,67,71] were the most frequently reported enablers.…”

“…Communicating about health and care: telemedicine and teleconsultation platforms (telephone, SMS text messaging, and video) [35][36][37][38][39][40][41][42] and appointment reminders [36] • Health and care diaries: mobile apps to track and record users' health information for self-monitoring [43,44] • Promoting good health: internet-based health information [45,46] and nonpersonalized health education via SMS text messaging [47,48] Tier C…”

Impact of the COVID-19 Pandemic on Palliative Care in Cancer Patients in Spain

“…The pandemic also saw a slight fall in the number of cancer patients and therefore in the number of caregivers. Fear of contagion reduced the number of interactions by creating a restrictive environment [11]. Social distancing measures affected the availability not only of the health services, but also those of social support, placing an additional burden on caregivers, many of whom have cut themselves off from normal family and social networks in order to fulfil their obligations [32].…”

“…The outbreak of the COVID-19 pandemic has profoundly affected healthcare organizations around the world [10], posing serious ethical challenges [6,11]. In particular, there have been many negative changes in the provision of PC services.…”