Cancer Patient-Reported Experience Measures (PREMs) Regarding the Policies Implemented to Contain the Spread of Sars-CoV-2 and Vaccination Campaign at Veneto Institute of Oncology
Abstract:The SARS-CoV-2 spread has impacted Healthcare systems. COVID-19 pandemic has had consequences for patients with cancer, being associated with delays in diagnosis, in treatment And follow-up care, increase in overall infection rates and higher mortality. A survey on COVID-19 and a vaccination-questionnaire were developed at different times of the outbreak, to evaluate cancer patient-reported experience measures (PREMs) on the policies implemented to reduce the infection from SARS-CoV-2 and on the timing and met… Show more
“…Measuring patients' satisfaction is necessary to improve the provision of SCOC 17 . Involving patients in the organization reframing of services can lead to authentic personalized medicine, and help healthcare providers making choices which are both informed and consistent with patients' needs 18 …”
Section: Discussionmentioning
confidence: 99%
“…17 Involving patients in the organization reframing of services can lead to authentic personalized medicine, and help healthcare providers making choices which are both informed and consistent with patients' needs. 18 Patients with advanced cancer have a high burden of unmet needs, with special regard to symptoms control, psychological and emotional support and communication. 19,20 There is evidence showing that dissatisfaction with medical information and communication is associated with anxiety and depression which, in turn, contribute to the global burden of disability in patients with advanced cancer.…”
BackgroundVeneto Institute of Oncology has activated a simultaneous care outpatient clinic (SCOC) in which cancer patients with advanced‐stage cancer are evaluated by oncologist and palliative care specialists. This cross‐sectional study investigated patients' perceptions of the quality of this service.Materials and MethodsAn ad‐hoc self‐administered questionnaire, developed by SCOC team, was used to assess the satisfaction of patients admitted at SCOC consultation. The questionnaire, in addition to the socio‐demographic questions, contains eight questions with the Likert scale: time dedicated, feel listened to, feel understood, feel free to speak openly and to express doubts and concerns, feeling about information and indication received, level of empathy of health care and quality of the relationship, level of professional/quality of performance and utility of consultation, and one open‐ended question. The questionnaire has been proposed to all 174 consecutively admitted patients at SCOC.ResultsOne hundred and sixty‐two patients filled in the questionnaire: 66.7% were male, median age was 71 years, 88.3% had metastatic disease. The time dedicated to SCOC consultation was judged more than adequate (55%) or adequate (35%) by 90% of subjects. Patients completely satisfied about being listened to were 92.5%, with 80.9% being completely satisfied with understanding of their issues and 92% with the freedom to speak and express doubts. Usefulness of the SCOC was rated as excellent by 40% and good by 54.4% of patients. No statistically significant differences were observed in the responses to the questions by gender, age (< or ≥70 years old) and type of tumor.ConclusionOur study shows high levels of satisfactions after SCOC consultation in advanced cancer subjects. Patients' feedback confirmed that SCOC model was effective in helping them during their treatment journey and decision at the end of life. This study encouraged us to enhance our practice of SCOC consultation.Implications for PracticeA joint evaluation of patients living with cancer by oncologist and palliative care team (SCOC‐embedded model), has shown to enhance patients' experience/satisfaction with care‐such as listening, understanding, receiving information, symptom control, and decision about future, independently of age, gender, and kind of tumor.
“…Measuring patients' satisfaction is necessary to improve the provision of SCOC 17 . Involving patients in the organization reframing of services can lead to authentic personalized medicine, and help healthcare providers making choices which are both informed and consistent with patients' needs 18 …”
Section: Discussionmentioning
confidence: 99%
“…17 Involving patients in the organization reframing of services can lead to authentic personalized medicine, and help healthcare providers making choices which are both informed and consistent with patients' needs. 18 Patients with advanced cancer have a high burden of unmet needs, with special regard to symptoms control, psychological and emotional support and communication. 19,20 There is evidence showing that dissatisfaction with medical information and communication is associated with anxiety and depression which, in turn, contribute to the global burden of disability in patients with advanced cancer.…”
BackgroundVeneto Institute of Oncology has activated a simultaneous care outpatient clinic (SCOC) in which cancer patients with advanced‐stage cancer are evaluated by oncologist and palliative care specialists. This cross‐sectional study investigated patients' perceptions of the quality of this service.Materials and MethodsAn ad‐hoc self‐administered questionnaire, developed by SCOC team, was used to assess the satisfaction of patients admitted at SCOC consultation. The questionnaire, in addition to the socio‐demographic questions, contains eight questions with the Likert scale: time dedicated, feel listened to, feel understood, feel free to speak openly and to express doubts and concerns, feeling about information and indication received, level of empathy of health care and quality of the relationship, level of professional/quality of performance and utility of consultation, and one open‐ended question. The questionnaire has been proposed to all 174 consecutively admitted patients at SCOC.ResultsOne hundred and sixty‐two patients filled in the questionnaire: 66.7% were male, median age was 71 years, 88.3% had metastatic disease. The time dedicated to SCOC consultation was judged more than adequate (55%) or adequate (35%) by 90% of subjects. Patients completely satisfied about being listened to were 92.5%, with 80.9% being completely satisfied with understanding of their issues and 92% with the freedom to speak and express doubts. Usefulness of the SCOC was rated as excellent by 40% and good by 54.4% of patients. No statistically significant differences were observed in the responses to the questions by gender, age (< or ≥70 years old) and type of tumor.ConclusionOur study shows high levels of satisfactions after SCOC consultation in advanced cancer subjects. Patients' feedback confirmed that SCOC model was effective in helping them during their treatment journey and decision at the end of life. This study encouraged us to enhance our practice of SCOC consultation.Implications for PracticeA joint evaluation of patients living with cancer by oncologist and palliative care team (SCOC‐embedded model), has shown to enhance patients' experience/satisfaction with care‐such as listening, understanding, receiving information, symptom control, and decision about future, independently of age, gender, and kind of tumor.
“…We found that with proper patient education, vaccination and clinical screening for symptoms or viral exposure, we maintained the outpatient clinical arena largely free of SARS-CoV-2, 12 with good patient's satisfaction. 26 Moreover, given the rapid and benign evolution of the infection, we recommend considering continuing with systemic anticancer treatment, especially in patients undergoing treatment with curative intent.…”
Background
Routine testing for cancer patients not presenting COVID‐19‐related symptoms and fully vaccinated for SARS‐CoV‐2 prior to cancer treatment is controversial.
Methods
In this retrospective study we evaluated whether antigen‐rapid‐diagnostic‐test (Ag‐RDT) monitoring for SARS‐CoV‐2 in a large cohort of consecutive asymptomatic (absence of SARS‐CoV‐2‐related symptoms such as fever, cough, sore throat or nasal congestion) and fully vaccinated cancer patients enrolled in a short period during cancer treatment has an impact on the therapeutic path of cancer patients.
Results
From December 27, 2021, to February 11, 2022, 2439 cancer patients were screened through Ag‐RDT for SARS‐CoV‐2 before entering the hospital for systemic treatment. Fifty‐three patients (2.17%) tested positive, of whom 7 (13.2%) subsequently developed COVID‐related symptoms, generally mild. Cancer treatment was discontinued, as a precaution, in 49 patients (92.5%) due to the test positivity.
Conclusion
SARS‐CoV‐2 screening in asymptomatic and fully vaccinated cancer patients during systemic treatment appeared to be not cost‐effective: the low rate of SARS‐CoV‐2 positive patients and the low percentage of overt associated infection do not seem proportional to the direct costs (nursing work for swabs, costs of materials and patient monitoring) and indirect costs (dedicated rooms, extension of waiting times for patients and oncologists in delivering therapy as well as its discontinuation in the positive ones). It can, on the other hand, be detrimental when systemic cancer treatment is suspended as a precaution. Given the small number of patients testing positive and the rapid and favorable trend of the infection, it is recommended to always consider continuing systemic oncological treatment, especially when this impacts patient survival as in the adjuvant or neoadjuvant setting.
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