scholarly journals Impact of COVID-19 pandemic on the oncologic care continuum: urgent need to restore patients care to pre-COVID-19 era

2021 ◽  
pp. 1-11
Author(s):  
Ernest Osei ◽  
Ruth Francis ◽  
Ayan Mohamed ◽  
Lyba Sheraz ◽  
Fariba Soltani-Mayvan
Keyword(s):  
Cancer Care ◽  
Healthcare Professionals ◽  
Negative Impact ◽  
System Level ◽  
Care Continuum ◽  
Cancer Services ◽  
Number Of Patients ◽  
Prevention Programmes ◽  
Screening And Prevention ◽  
The Impact

Abstract Background: Globally, cancer is the second leading cause of death, and it is estimated that over 18·1 million new cases are diagnosed annually. The COVID-19 pandemic has significantly impacted almost every aspect of the provision and management of cancer care worldwide. The time-critical nature of COVID-19 diagnosis and the large number of patients requiring hospitalisation necessitated the rerouting of already limited resources available for cancer services and programmes to the care of COVID-19 patients. Furthermore, the stringent social distancing, restricted in-hospital visits and lockdown measures instituted by various governments resulted in the disruption of the oncologic continuum including screening, diagnostic and prevention programmes, treatments and follow-up services as well as research and clinical trial programmes. Materials and Methods: We searched several databases from October 2020 to January 2021 for relevant studies published in English between 2020 and 2021 and reporting on the impact of COVID-19 on the cancer care continuum. This narrative review paper describes the impact of the COVID-19 pandemic on the cancer patient care continuum from screening and prevention to treatments and ongoing management of patients. Conclusions: The COVID-19 pandemic has profoundly impacted cancer care and the management of cancer services and patients. Nevertheless, the oncology healthcare communities worldwide have done phenomenal work with joint and collaborative efforts, utilising best available evidence-based guidelines to continue to give safe and effective treatments for cancer patients while maintaining the safety of patients, healthcare professionals and the general population. Nevertheless, several healthcare centres are now faced with significant challenges with the management of the backlog of screening, diagnosis and treatment cases. It is imperative that governments, leaders of healthcare centres and healthcare professionals take all necessary actions and policies focused on minimising further system-level delays to cancer screening, diagnosis, treatment initiation and clearing of all backlogs cases from the COVID-19 pandemic in order to mitigate the negative impact on cancer outcomes.

scholarly journals A Cross-Sectional Survey Exploring the Impact of the COVID-19 Pandemic on the Cancer Care of Adolescents and Young Adults

2021 ◽  
Vol 28 (4) ◽  
pp. 3201-3213
Author(s):  
Kaitlyn Howden ◽  
Camille Glidden ◽  
Razvan G. Romanescu ◽  
Andrew Hatala ◽  
Ian Scott ◽  
...  
Keyword(s):  
Young Adults ◽  
Cancer Treatment ◽  
Cancer Care ◽  
Negative Impact ◽  
Positive Impact ◽  
Care Delivery ◽  
Adolescents And Young Adults ◽  
P Value ◽  
Cross Sectional Survey ◽  
The Impact

We aimed to describe the negative and positive impacts of changes in cancer care delivery due to COVID-19 pandemic for adolescents and young adults (AYAs) in Canada, as well as the correlates of negative impact and their perspectives on optimization of cancer care. We conducted an online, self-administered survey of AYAs with cancer living in Canada between January and February 2021. Multiple logistic regression was used to identify factors associated with a negative impact on cancer care. Of the 805 participants, 173 (21.5%) experienced a negative impact on their cancer care including delays in diagnostic tests (11.9%), cancer treatment (11.4%), and appointments (11.1%). A prior diagnosis of mental or chronic physical health condition, an annual income of <20,000 CAD, ongoing cancer treatment, and province of residence were independently associated with a negative cancer care impact (p-value < 0.05). The majority (n = 767, 95.2%) stated a positive impact of the changes to cancer care delivery, including the implementation of virtual healthcare visits (n = 601, 74.6%). Pandemic-related changes in cancer care delivery have unfavorably and favorably influenced AYAs with cancer. Interventions to support AYAs who are more vulnerable to the adverse effects of the pandemic, and the thoughtful integration of virtual care into cancer care delivery models is essential.

scholarly journals The Impact of Debt Burden on the Number of Suicides in the Russian Regions

2021 ◽  
Vol 17 (4) ◽  
pp. 97-117
Author(s):  
Svetlana Doroshenko ◽  
◽  
Olga Sanaeva ◽  
◽  
Keyword(s):  
Mental Disorders ◽  
Unemployment Rate ◽  
Rural Areas ◽  
Negative Impact ◽  
Generalized Method Of Moments ◽  
Russian Regions ◽  
Debt Burden ◽  
Suicide Rates ◽  
Number Of Patients ◽  
The Impact

Population size is one of the most important parameters of national social and economic systems. This parameter is controlled by a variety of factors (components) that form ambiguous and complex feedback circuits. The most important issue is the study of the behavioral reactions of the population, which form certain parameters of the dynamics of the population. The authors consider only one behavioral reaction that seems to them to be important – the propensity for suicide, which ultimately leads to the formation of the suicide dynamics and which entails serious socio-economic and demographic losses. We put an emphasis on assessing the impact of financial parameters, namely households’ debt burden, on the suicide rates in the Russian regions. An econometric assessment of the influence of individual debt on the number of suicides among other socio-economic factors (unemployment rate, logarithm of GRP per capita, divorce rate, number of patients with mental disorders, average actual working week, number of alcoholics) was carried out for the regions among rural, urban populations and total. We use panel data for 80 Russian regions covering the period from 2005 to 2018. We apply the generalized method of moments (GMM) using Stata 14 statistical package. The empirical analysis demonstrates negative impact of the amount of individual debt on the number of suicides in the regions of Russia, which contradicts the results of similar studies conducted for developed economies. At the same time, some results obtained earlier in domestic and foreign studies have been confirmed, including an existence of a parabolic (U-shaped) dependence between the length of working hours and the suicide rates in the regions of the Russian Federation. In addition, there is a direct connection between an increase in the committed suicides and an increase in divorce rates and the number of patients with mental disorders. Moreover, we find out that the rise in unemployment rate and alcohol consumption leads to an increase in the number of committed suicides. This effect is especially perceptible among the people living in rural areas

scholarly journals Impact of enhanced personal protective equipment on the physical and mental well-being of healthcare workers during COVID-19

2020 ◽  
pp. postgradmedj-2020-139150 ◽  
Author(s):  
Ramanathan Swaminathan ◽  
Bimantha Perera Mukundadura ◽  
Shashi Prasad
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Negative Impact ◽  
Well Being ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Cross Sectional ◽  
The Impact ◽  
Mental Well Being

BackgroundThe COVID-19 pandemic has necessitated the use of enhanced personal protective equipment (PPE) in healthcare workers in patient-facing roles. We describe the impact on the physical and mental well-being of healthcare professionals who use enhanced PPE consistently.MethodsWe conducted a single-centre, cross-sectional study among healthcare professionals who use enhanced PPE. A web-based questionnaire was disseminated to evaluate the effects on individuals’ physical and mental well-being. Physical and mental impact was assessed through a visual analogue scale.ResultsProspective analysis of the views of 72 respondents is reported. 63.9% were women and 36.1% were men. Physical impact included exhaustion, headache, skin changes, breathlessness and a negative impact on vision. Communication difficulties, somnolence, negative impact on overall performance and difficulties in using surgical instrumentation were reported.ConclusionOur study demonstrates the undeniable negative impact on the front-line healthcare workers using enhanced PPE and lays the ground for larger multicentric assessments given for it to potentially be the norm for the foreseeable future.

scholarly journals Using Quality Improvement Methods and Time-Driven Activity-Based Costing to Improve Value-Based Cancer Care Delivery at a Cancer Genetics Clinic

2016 ◽  
Vol 12 (3) ◽  
pp. e320-e331 ◽  
Author(s):  
Ryan Y.C. Tan ◽  
Marie Met-Domestici ◽  
Ke Zhou ◽  
Alexis B. Guzman ◽  
Soon Thye Lim ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Cancer Care ◽  
Cancer Genetics ◽  
Care Delivery ◽  
Genetic Counselor ◽  
Activity Based Costing ◽  
Improvement Project ◽  
Personnel Costs ◽  
Number Of Patients ◽  
The Impact

Purpose: To meet increasing demand for cancer genetic testing and improve value-based cancer care delivery, National Cancer Centre Singapore restructured the Cancer Genetics Service in 2014. Care delivery processes were redesigned. We sought to improve access by increasing the clinic capacity of the Cancer Genetics Service by 100% within 1 year without increasing direct personnel costs. Methods: Process mapping and plan-do-study-act (PDSA) cycles were used in a quality improvement project for the Cancer Genetics Service clinic. The impact of interventions was evaluated by tracking the weekly number of patient consultations and access times for appointments between April 2014 and May 2015. The cost impact of implemented process changes was calculated using the time-driven activity-based costing method. Results: Our study completed two PDSA cycles. An important outcome was achieved after the first cycle: The inclusion of a genetic counselor increased clinic capacity by 350%. The number of patients seen per week increased from two in April 2014 (range, zero to four patients) to seven in November 2014 (range, four to 10 patients). Our second PDSA cycle showed that manual preappointment reminder calls reduced the variation in the nonattendance rate and contributed to a further increase in patients seen per week to 10 in May 2015 (range, seven to 13 patients). There was a concomitant decrease in costs of the patient care cycle by 18% after both PDSA cycles. Conclusion: This study shows how quality improvement methods can be combined with time-driven activity-based costing to increase value. In this paper, we demonstrate how we improved access while reducing costs of care delivery.

scholarly journals A Survey of the Impact Lockdown Due to COVID-19 Pandemic on the Volume of Patients Accessing Breast Cancer Care in Nigeria

2020 ◽  
Vol 4 (2) ◽  
pp. 77-85
Author(s):  
Olayide S. Agodirin ◽  
Ganiyu A. Rahman ◽  
Samuel A. Olatoke ◽  
Isiaka Aremu ◽  
Asimiyu A. Shittu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Microsoft Excel ◽  
Southwestern Nigeria ◽  
North Central ◽  
Resource Setting ◽  
Cancer Services ◽  
Definitive Surgery ◽  
Chemotherapy Patients ◽  
The Impact

Background: The coronavirus disease 2019 (COVID-19) pandemic has disrupted cancer care, among others and increased the suffering of breast cancer (BC) patient owing to the imposed lockdown. This is study investigated the impact of COVID-19 lockdown on the volume of BC patients accessing care in a poor resource setting . Methods: We surveyed general surgery units (GSU) in North central and Southwestern Nigeria during the first lockdown in April/May 2020. Using an electronically mailed questionnaire, we requested data on patients accessing clinics, chemotherapy and definitive surgery before and during lockdown. The data were analyzed and presented in descriptive statistics using SPSS v 20 and Microsoft Excel software. Results: Among the 22 GSUs, only 5(23%) prepared for maintaining oncology or breast cancer services during the lockdown. Compared to the volume before the lockdown, 15(60%) GSUs received <30% of the usual volume of new cases, 16 (73%) received <30% of the usual of patients chemotherapy patients and no patient accessed definitive surgery in 15 (68%) GSUs. Conclusion: There was a marked reduction in the volume of BC patients accessing outpatient clinics, chemotherapy facilities, and definitive surgery during the COVID-19 lockdown

scholarly journals The Impact of the COVID-19 Pandemic on Cancer Patient’s Management—Lithuanian Cancer Center Experience

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1522
Author(s):  
Daiva Dabkeviciene ◽  
Ieva Vincerzevskiene ◽  
Vincas Urbonas ◽  
Jonas Venius ◽  
Audrius Dulskas ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Early Period ◽  
Disease Stage ◽  
Cancer Center ◽  
Insurance Fund ◽  
Tumor Type ◽  
Contingency Table Analysis ◽  
Cancer Services ◽  
Number Of Patients ◽  
The Impact

The pandemic spread of the COVID-19 virus significantly affected daily life, but the highest pressure was piled on the health care system. Our aim was to evaluate an impact of COVID-19 pandemic management measures on cancer services at the National Cancer Institute (NCI) of Lithuania. We assessed the time period from 1 February 2020 to 31 December 2020 and compared it to the same period of 2019. Data for our analysis were extracted from the NCI Hospital Information System (HIS) and the National Health Insurance Fund (NHIF). Contingency table analysis and ANOVA were performed. The COVID-19 pandemic negatively affected the cancer services provided by NCI. Reductions in diagnostic radiology (−16%) and endoscopy (−29%) procedures were accompanied by a decreased number of patients with ongoing medical (−30%), radiation (−6%) or surgical (−10%) treatment. The changes in the number of newly diagnosed cancer patients were dependent on tumor type and disease stage, showing a rise in advanced disease at diagnosis already during the early period of the first lockdown. The extent of out-patient consultations (−14%) and disease follow-up visits (−16%) was also affected by the pandemic, and only referrals to psychological/psychiatric counselling were increased. Additionally, the COVID-19 pandemic had an impact on the structure of cancer services by fostering the application of modified systemic anticancer therapy or hypofractionated radiotherapy. The most dramatic drop occurred in the number of patients participating in cancer prevention programs; the loss was 25% for colon cancer and 62% for breast cancer screening. Marked restriction in access to preventive cancer screening and overall reduction of the whole spectrum of cancer services may negatively affect cancer survival measures in the nearest future.

Extrapulmonary tuberculosis during the COVID-19 pandemic: features of detection and course

2021 ◽  
pp. 585-589
Author(s):  
Ekaterina V. Kulchavenia ◽  
◽  
Ekaterina V. Kulchavenia ◽  
Keyword(s):  
Negative Impact ◽  
Extrapulmonary Tuberculosis ◽  
Abdominal Tuberculosis ◽  
First Year ◽  
Large Variability ◽  
Number Of Patients ◽  
Federal Districts ◽  
Novel Coronavirus ◽  
Far Eastern ◽  
The Impact

Background. COVID-19 pandemic caused by novel coronavirus has destabilized the world's health systems, revealing flaws in the organization of work in extreme conditions. Currently, there is limited empirical data on the impact of COVID-19 on tuberculosis outcomes. Materials and methods. Non-interventional comparative retrospective cohort study of the structure of the incidence of extrapulmonary tuberculosis (EPTB) in the Siberian and Far Eastern Federal Districts for the period 1999–2020 was carried out. Data of 13 852 patients were analyzed. Results. Of all 13 852 EPTB patients who were first diagnosed during the study period, the majority of cases (973) were registered in 1999, and the smallest number (550) – in 2017. Then, for 2 years, an increase in EPTB incidence was observed again (582 cases in 2018, and 563 cases in 2019) with a natural reduction by 18.5% in 2020 (459 cases). Over the first year of the COVID-19 epidemic, the incidence of central nervous system tuberculosis decreased by almost half (by 45.9%), the incidence of peripheral lymph nodes tuberculosis remained virtually unchanged, and the number of cases of "other" localizations, mainly abdominal tuberculosis, increased by 55.3%. Overall, in the Siberian and Far Eastern Federal Districts, the detection of isolated forms of EPTB over the first year of the pandemic reduced by 18.5% (from 563 to 459 patients). A large variability of data was found across regions. Thus, in the Novosibirsk, Tomsk and Omsk regions there was a significant decrease in the number of patients diagnosed with isolated EPTB (by 30.2; 47.1 and 64.5%, respectively) while in the Kemerovo and Irkutsk regions, the number of patients with isolated EPTB increased (by 80.9 and 32.3%, respectively). Conclusion. COVID-19 has had a significant negative impact on all services of national and global healthcare, the ultimate losses we have yet to calculate. Diagnostics of any diseases, and particularly EPTB, in the first year of the pandemic was difficult due to the restriction of patient visits to medical and preventive institutions, the closure or re-profiling of some of them, as well as a decrease in the number of specialists due to their selfisolation, re-profiling and COVID-19 disease. Nevertheless, the role of EPTB is still important.

Impact of the COVID-19 pandemic on care delivery and outcomes for patients with metastatic pancreatic ductal adenocarcinoma (mPDAC).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 4137-4137
Author(s):  
Ravi Kumar Paluri ◽  
Paul Cockrum ◽  
Ashley Ann Laursen ◽  
Joseph Louis Gaeta ◽  
Shu Wang ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Cancer Care ◽  
De Novo ◽  
Care Delivery ◽  
Stage Iv ◽  
Ductal Adenocarcinoma ◽  
Similar Proportion ◽  
Number Of Patients ◽  
The Us ◽  
The Impact

4137 Background: The coronavirus disease 2019 (COVID-19) pandemic has caused abrupt changes to the US health system and disruption in cancer care delivery. Little has been reported on the impact of COVID-19 on patients with mPDAC and the care delivery. Our study aimed to characterize the impact of COVID-19 on healthcare utilization and outcomes for patients with mPDAC in the US in the community oncology setting. Methods: We performed a retrospective cohort study of adult patients diagnosed with mPDAC between March – September 2019 and March – September 2020 using the nationwide Flatiron Health EHR database, comprising data from over 280 (largely community based) cancer clinics. Patients were stratified into two cohorts based on the year of diagnosis (2019 vs. 2020). Clinical characteristics were summarized including age at metastatic diagnosis, stage at initial diagnosis, and ECOG performance score (PS). Overall survival (OS) from metastatic diagnosis was estimated using Kaplan-Meier methods. A sensitivity analysis limiting the follow-up time to November of each year was conducted. Results: Overall, 1,719 patients were included in the study (2019: n = 923, 2020: n = 796); both cohorts had similar demographic compositions in terms of age and sex (2019: median age = 70 (IQR: 62 – 76), 52.2% male; 2020: median age = 70 [IQR: 62 – 76], 53.5% male). In 2020, the number of newly diagnosed mPDAC patients decreased by 13.8% compared to 2019. A slightly higher proportion of patients were initially diagnosed with stage IV disease in 2020 (69.7%) vs 2019 (62.3%). A similar proportion of patients with ECOG PS 0-1 was observed between the two cohorts (2019: 48.5%; 2020: 47.9%). The number of visits recorded within the first 90 days after metastatic diagnosis was similar between the two cohorts (2019: median 8 [IQR: 3 – 14]; 2020: median 9 [IQR: 4 – 14]). For both cohorts, the proportion of patients who received 1L treatment was similar (2019: 75.8%; 2020: 76.5%), and the most common 1L treatment regimen was gemcitabine plus nab-paclitaxel (2019: 37.6%; 2020: 40.9%). Of the 1L treated populations, 37.6% of patients diagnosed in 2019 received second line (2L) compared to 17.9% of the 2020 cohort; 16.9% of 1L treated patients in 2019 received 2L in the sensitivity analysis. Patients diagnosed in 2020 had a significantly lower median OS of 6.1 months (95% CI: 5.4 – 6.9) compared to patients diagnosed in 2019: 8.4 months (7.5 – 9.0) (p < 0.001). Conclusions: During the COVID-19 pandemic era, the diagnoses of de novo mPDAC appears to have been impacted, with a higher number of patients diagnosed with advanced stage at presentation. Our analysis suggests that while patients diagnosed in 2020 received a similar level of care as those in 2019, their survival outcomes were adversely affected. Further research is necessary to characterize the impact of the COVID-19 pandemic on cancer care and outcomes.

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