Impact of COVID-19 on cancer service delivery: results from an international survey of oncology clinicians

Chazan, Grace; Franchini, Fanny; Alexander, Marliese; Banerjee, Susana; Mileshkin, Linda; Blinman, Prunella; Zielinski, Robert; Karikios, Deme; Pavlakis, Nick; Peters, Solange; Lordick, Florian; Ball, David; Wright, Gavin; IJzerman, Maarten Joost; Solomon, Benjamin

doi:10.1136/esmoopen-2020-001090

Cited by 20 publications

(38 citation statements)

References 13 publications

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“…In November of 2020, we published results from an international survey of oncology clinicians (conducted May-June 2020), with pertinent findings including 89% of oncology clinicians reporting altering cancer management, significantly fewer patient consultations per week and an almost 8-fold increase in use of telehealth for patient consultations, with many clinicians expressing concerns that increased telehealth use may negatively impact patient outcomes. 1 Here, we describe findings from a follow-up survey, conducted from 27 th September to 7 th J o u r n a l P r e -p r o o f November, intended to explore how attitudes and practices evolved over the pandemic period in 2020.…”

Section: Highlightsmentioning

confidence: 99%

Impact of COVID-19 on cancer service delivery: a follow-up international survey of oncology clinicians

Chazan¹,

Franchini²,

Alexander³

et al. 2021

ESMO Open

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Highlightsmentioning

confidence: 99%

Impact of COVID-19 on cancer service delivery: a follow-up international survey of oncology clinicians

Chazan¹,

Franchini²,

Alexander³

et al. 2021

ESMO Open

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“…This survey reported a 7.7-fold increase in the proportion of consultations using telehealth, however 25% of clinicians reported concerns that increased telehealth could lead to a worsened patient survival because of less frequent physical assessments. 13 Concerns about the psychological impact of new models of care should also be taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

“…Our survey does not put the responses into the context of case numbers at the time of the survey, however the survey by Chazan et al reports that 88.8% of respondents altered cancer management or the delivery of cancer services, with similar rates across Europa, Asia and Australia/ New Zealand, despite disparities in COVID-19 case numbers. 13 The survey was open for a short duration, only capturing a snapshot of experiences and strategies implemented during the pandemic. It is possible that there is respondent bias in the sense that respondents working in hospitals implementing strategies aimed at patient prioritisation were more willing to take part in the survey.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Global changes to the chemotherapy service during the covid-19 pandemic

Chow

Chambers

Singleton

et al. 2021

J Oncol Pharm Pract

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Purpose In response to the COVID-19 pandemic, changes to chemotherapy services were implemented as a means of managing imposed workload strains within health services and protecting patients from contracting COVID-19. Given the rapidly evolving nature of the pandemic many changes were rapidly adopted and were not substantiated by robust evidence. This study aimed to describe the changes adopted internationally to chemotherapy services, which may be used to guide future changes to treatment delivery. Methods A survey was developed to understand the impact of COVID-19 on the delivery of systemic anti-cancer therapies (SACT). It comprised 22 questions and examined the strategies implemented during the pandemic to prioritise and protect patients receiving SACT and the participants’ professional opinion of the strategies employed. The survey was available in English, Spanish and French and was distributed via professional bodies. Results 129 responses were obtained from healthcare professionals working across 17 different countries. 45% of institutions had to implement treatment prioritisation strategies and all hospitals implemented changes in the delivery of treatment, including: reduction in treatments (69%), using less immunosuppressive agents (50%), allowing treatment breaks (14%) and switching to oral therapies (45%). Virtual clinic visits were perceived by participants as the most effective strategy to protect patients. Conclusions The pandemic has forced chemotherapy healthcare professionals to adopt new ways of working by reducing health interactions. Many areas of research are needed following this period, including understanding patients’ perceptions of risks to treatment, utilisation of oral treatments and the impact of treatment breaks on cancer outcomes.

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“…Expert panels have proposed strategies to balance cancerrelated risks and benefits with the increased risk of COVID-19 [11,12], leading some institutions to delay treatments and nonurgent interventions in order to encourage social distancing [13,14]. Delays in cancer treatment may increase 5-year cancer-related mortality by 4.8%-16.6% (depending on cancer type) [15]; delaying cancer care has been found to be associated with increased cancer-specific mortality, which exceeds COVID-19 mortality [16].…”

Section: Introductionmentioning

confidence: 99%

Clinical Impact of the COVID-19 Pandemic in Mexican Patients with Thoracic Malignancies

et al. 2021

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Background. Accumulated evidence indicates that patients with lung cancer are a vulnerable population throughout the pandemic. Limited information is available in Latin America regarding the impact of the pandemic on medical care. The goal of this study was to describe the clinical and social effect of COVID-19 on patients with thoracic cancer and to ascertain outcomes in those with a confirmed diagnosis. Materials and Methods. This cohort study included patients with thoracic neoplasms within a single institution between March 1, 2020, and February 28, 2021. All variables of interest were extracted from electronic medical records. During this period, the Depression Anxiety and Stress Scale 21 (DASS-2) was applied to evaluate and identify more common psychological disorders. Results. The mean age for the total cohort (n = 548) was 61.5 AE 12.9 years; non-small cell lung cancer was the most frequent neoplasm (86.9%), advanced stages predominated (80%), and most patients were under active therapy (82.8%). Any change in treatment was reported in 23.9% of patients, of which 78.6% were due to the COVID-19 pandemic. Treatment delays (≥7 days) were the most frequent modifications in 41.9% of cases, followed by treatment suspension at 37.4%. Patients without treatment changes had a more prolonged progression-free survival and overall survival (hazard ratio [HR] 0.21, p < .001 and HR 0.28, p < .001, respectively). The mean DASS-21 score was 10.45 in 144 evaluated patients, with women being more affected than men (11.41 vs. 9.08, p < .001). Anxiety was reported in 30.5% of cases, followed by depression and distress in equal proportions (18%). Depressed and stressed patients had higher odds of experiencing delays in treatment than patients without depression (odds ratio [OR] 4.5, 95% confidence interval [CI] 1.53-13.23, p = .006 and OR 3.18, 95% CI 1.2-10.06, p = .006, respectively). Conclusion.Treatment adjustments in patients with thoracic malignancies often occurred to avoid COVID-19 contagion with detrimental effects on survival. Psychological disorders could have a role in adherence to the original treatment regimen. The Oncologist 2021;25:1-9Implications for Practice: The pandemic has placed an enormous strain on health care systems globally. Patients with thoracic cancers represent a vulnerable population, with increased morbidity and mortality rates. In Mexico, treatment modifications were common during the pandemic, and those who experienced delays had worse survival outcomes. Most treatment modifications were related to a patient decision rather than a lockdown of health care facilities in which mental health impairment plays an essential role. Moreover, the high case fatality rate highlights the importance of improving medical care access. Likewise, to develop strategies facing future threats that may compromise health care systems in non-developed countries.

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Impact of COVID-19 on cancer service delivery: results from an international survey of oncology clinicians

Cited by 20 publications

References 13 publications

Impact of COVID-19 on cancer service delivery: a follow-up international survey of oncology clinicians

Impact of COVID-19 on cancer service delivery: a follow-up international survey of oncology clinicians

Global changes to the chemotherapy service during the covid-19 pandemic

Clinical Impact of the COVID-19 Pandemic in Mexican Patients with Thoracic Malignancies

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