The Impact of COVID-19 Outbreak on Uro-oncological Practice Across Europe: Which Burden of Activity Are We Facing Ahead?

Oderda, Marco; Rouprêt, Morgan; Marra, Giancarlo; Merseburger, Axel S.; Oderda, Gianluca; Falcone, Marco; Ceruti, C.; Shariat, Shahrokh F.; Gontero, P.

doi:10.1016/j.eururo.2020.04.036

Cited by 35 publications

(38 citation statements)

References 3 publications

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“…During the pandemic, many "non-urgent" surgeries have been cancelled or delayed, including oncological surgery. Thus there is a risk of an oncological healthcare crisis [2]. Although some prostate cancer management can be delayed for a few weeks with a low risk of progression, it is not recommended for bladder or testicular cancer as it can impact outcome and survival [22].…”

Section: Discussionmentioning

confidence: 99%

“…On March 16th, the French Association of Urology recommended that every non-urgent consultation should be delayed and non-urgent surgery postponed [1]. This major decision could have a negative impact on patients, particularly those diagnosed with urological cancers [2]. Patients could also neglect relevant symptoms placing them in a dangerous situation.…”

Section: Introductionmentioning

confidence: 99%

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Preliminary assessment of patient and physician satisfaction with the use of teleconsultation in urology during the COVID-19 pandemic

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Purpose Lockdown during the COVID-19 pandemic compelled urologists to change access to healthcare, especially for oncology patients. Teleconsultation is a safe way to receive medical advice without a risk of infection, and was implemented urgently in our academic centres. Our purpose was to evaluate patient and physician satisfaction with teleconsultation set up during the COVID-19 pandemic. Methods From March 16th 2020, all face-to-face consultations were cancelled in France, except for emergencies. Teleconsultation was started immediately by five senior urologists in two academic hospitals. All patients received an email survey including the validated Teleconsultation Satisfaction Questionnaire (TSQ) and demographic questions. Data were collected prospectively. Physicians also responded to the TSQ. Patient satisfaction was measured objectively with the validated 14-item TSQ. Each item was scored on a 5-point Likert scale. Factors associated with positive satisfaction with teleconsultation were assessed by multivariable logistic regression. Results Overall, 105 patients replied to the survey (91.3%). Median age was 66 years (IQR: 55-71) and 95 were men (90.5%). Median overall TSQ score was 67 (IQR: 60-69); teleconsultation was judged to be a good experience by 88 patients (83.8%) and four physicians (80%). Patients who met their surgeon for the first time were more likely to have a good experience (OR = 1.2 [95% CI 1.1-1.5], p = 0.03). Conclusion Introduced rapidly during the COVID-19 lockdown, urology teleconsultation attained a high level of satisfaction among both patients and physicians. A major change in telemedicine use is foreseen in the post COVID-19 era.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Preliminary assessment of patient and physician satisfaction with the use of teleconsultation in urology during the COVID-19 pandemic

et al. 2020

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“…They showed that the management of the main urological cancers has been altered dramatically by the COVID-19 pandemic, with most European centers (82%) declaring to be "much" or "very much" affected. Uro-oncological consultations for newly diagnosed cancers and follow-up were more than halved or almost suspended, in 55% and 71% of centers, respectively (5). Guidelines have been provided by major national and international scientific societies to aid physicians in the management of urological conditions during the COVID-19 outbreak.…”

Section: Introductionmentioning

confidence: 99%

Implementation and strategies to ensure adequate coordination within a Urology Department during the COVID-19 pandemic

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Purpose: to provide an update on the management of a Urology Department during the COVID-19 outbreak, suggesting strategies to optimize assistance to the patients, to implement telemedicine and triage protocols, to define pathways for hospital access, to reduce risk of contagious inside the hospital and to determine the role of residents during the pandemic. Materials and Methods: In May the 6 th 2020 we performed a review of the literature through online search engines (PubMed, Web of Science and Science Direct). We looked at recommendations provided by the EAU and ERUS regarding the management of urological patients during the COVID-19 pandemic. The main aspects of interest were: the definition of deferrable and non-deferrable procedures, Personal Protective Equipment (PPE) and hospital protocols for health care providers, triage, hospitalization and surgery, post-operative care training and residents' activity. A narrative summary of guidelines and current literature for each point of interest was performed. Conclusion: In the actual Covid-19 scenario, while the number of positive patients globally keep on rising, it is fundamental to embrace a new way to deliver healthcare and to overcome challenges of physical distancing and self-isolation. The use of appropriate PPE, definite pathways to access the hospital, the implementation of telemedicine protocols can represent effective strategies to carry on delivering healthcare.

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“…Scaled up by constantly incoming new appointment requests, the burden of deferred elective patients critically rises with ongoing of the COVID-19 pandemic-particularly, as its end and the point of returning to pre-pandemic routines are uncertain [7]. In a tertiary care setting, we expect deferred elective patients to reach critical burden even faster than for higher prioritized oncologic patients [8], such that catching up on postponed visits may exceed capacities many times over. As treatment capacities cannot be expanded beyond a certain degree and distribution of health resources will likely become competitive, we will most likely face a supply shortfall for elective patients.…”

Section: Unmet Amount Of Elective Patientsmentioning

confidence: 99%

Confronting hidden COVID-19 burden: a telemedical solution for elective urological outpatient clinics

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Maintaining high-quality care for urological patients is a challenge during and after the Coronavirus disease 2019 (COVID-19) pandemic. We observe an increasing volume of postponed elective visits at our tertiary care hospital, holding the risk for deterioration of non-emergency disease conditions. As it is unclear for how long the pandemic will last, we propose to implement telehealth as a solution to provide regular symptom monitoring compatible with social distancing guidelines during the pandemic and beyond. Telemedical assessment and prioritizing of high-risk patients for individual consults at outpatient services will have to be aligned with available outpatient capacity and local outbreak severity.

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The Impact of COVID-19 Outbreak on Uro-oncological Practice Across Europe: Which Burden of Activity Are We Facing Ahead?

Cited by 35 publications

References 3 publications

Preliminary assessment of patient and physician satisfaction with the use of teleconsultation in urology during the COVID-19 pandemic

Preliminary assessment of patient and physician satisfaction with the use of teleconsultation in urology during the COVID-19 pandemic

Implementation and strategies to ensure adequate coordination within a Urology Department during the COVID-19 pandemic

Confronting hidden COVID-19 burden: a telemedical solution for elective urological outpatient clinics

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