A nurse-led telephone triage for the prevention and control of COVID-19 spread in an oncology department.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13617-e13617
Author(s):  
Lorenzo Calvetti ◽  
Francesca Simionato ◽  
Alessandro Cappetta ◽  
Francesca La Russa ◽  
Roberta Cimenton ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Cancer Patients ◽  
Health Workers ◽  
Veneto Region ◽  
Telephone Triage ◽  
Period 2 ◽  
Anticancer Treatment ◽  
Hospital Acquired ◽  
And Control ◽  
The Impact

e13617 Background: After the results of the Nurse-led Telephone Triage (NTT) study ( Calvetti L, et al. ASCO 2020), the system has been implemented to prevent unnecessary hospitalizations of cancer patients. With the pandemic outbreak, a dedicated SARS-CoV-2 2019 (COVID-19) NTT protocol was added to monitor cancer patients (CPs) receiving active medical treatment. We report on the impact of NTT in limiting accesses and minimizing the risk of spread of the infection through the Department of Oncology. Methods: CPs on active medical treatment were educated to call the NTT in case of any symptoms suspected for COVID-19 infection to the Oncology Department of Vicenza, Italy, during the COVID-19 pandemic (February 22 2020 to January 31, 2021). Each event assessment was performed by trained oncology nurses with the supervision of a medical oncologist on duty and in case of suspected COVID-19 infection a testing pathway for COVID-19 was activated. Primary endpoint of this study was to compare incidence of COVID-19 and related deaths in both CPs on active medical treatment and health workers with the rate in the overall population of Veneto region. Results: From February 22 2020 to January 31, 2021 1,154 patients received systemic anticancer treatment (versus 1,022 patients in the same 2019 – 2020 period). Total consultations at NTT were 587; 97 patients reported symptoms suspected for COVID-19 infections. The COVID-19 testing pathway was launched in 60 CPs and a positive test was reported in 25 CPs (2.2% incidence compared to 6.5% in the overall Veneto region population). Two COVID-19 related deaths were reported (8% death rate). In the same period, 2/54 (3.7%) health workers tested positive for COVID-19. Patients who tested positive had a median treatment delay of 25 days. Conclusions: The NTT system in the clinical practice provided a useful tool for monitoring and limiting hospital-acquired COVID-19 infection among both CPs on active treatment and health workers.

scholarly journals Clinical Impact of COVID-19 Outbreak on Cancer Patients: A Retrospective Study

2021 ◽  
Vol 15 ◽  
pp. 117955492110434
Author(s):  
Sebastiano Buti ◽  
Fabiana Perrone ◽  
Teresa Zielli ◽  
Giulia Mazzaschi ◽  
Chiara Casartelli ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Cancer Patients ◽  
Clinical Impact ◽  
Treatment Schedule ◽  
Short Term ◽  
Treatment Delays ◽  
Anticancer Treatment ◽  
Starting Failure ◽  
Oncologic Treatment ◽  
The Impact

Background: Coronavirus disease (COVID-19), an acute respiratory syndrome caused by a novel severe acute respiratory syndrome coronavirus (SARS-CoV-2), has rapidly spread worldwide, significantly affecting the outcome of a highly vulnerable group such as cancer patients. The aim of the present study was to evaluate the clinical impact of COVID-19 infection on outcome and oncologic treatment of cancer patients. Patient and methods: We retrospectively enrolled cancer patients with laboratory and/or radiologic confirmed SARS-CoV-2 infection, admitted to our center from February to April 2020. Descriptive statistics were used to summarize the clinical data and univariate analyses were performed to investigate the impact of anticancer treatment modifications due to COVID-19 outbreak on the short-term overall survival (OS). Results: Among 61 patients enrolled, 49 (80%) were undergoing anticancer treatment and 41 (67%) had metastatic disease. Most patients were men; median age was 68 years. Median OS was 46.6 days (40% of deaths occurred within 20 days from COVID-19 diagnosis). Among 59 patients with available data on therapeutic course, 46 experienced consequences on their anticancer treatment schedule. Interruption or a starting failure of the oncologic therapy correlated with significant shorter OS. Anticancer treatment delays did not negatively affect the OS. Lymphocytopenia development after COVID was significantly associated with worst outcome. Conclusions: COVID-19 diagnosis in cancer patients may affect their short-term OS, especially in case of interruption/starting failure of cancer therapy. Maintaining/delaying cancer therapy seems not to influence the outcome in selected patients with recent COVID-19 diagnosis.

scholarly journals An Antimethanogenic Nutritional Intervention in Early Life of Ruminants Modifies Ruminal Colonization by Archaea

Archaea ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Leticia Abecia ◽  
Kate E. Waddams ◽  
Gonzalo Martínez-Fernandez ◽  
A. Ignacio Martín-García ◽  
Eva Ramos-Morales ◽  
...  
Keyword(s):  
Community Composition ◽  
Early Life ◽  
Archaeal Community ◽  
Nutritional Intervention ◽  
The Other ◽  
Period 2 ◽  
Different Response ◽  
And Control ◽  
The Impact

The aim of this work was to study whether feeding a methanogen inhibitor from birth of goat kids and their does has an impact on the archaeal population colonizing the rumen and to what extent the impact persists later in life. Sixteen goats giving birth to two kids were used. Eight does were treated (D+) with bromochloromethane after giving birth and over 2 months. The other 8 goats were not treated (D−). One kid per doe in both groups was treated with bromochloromethane (k+) for 3 months while the other was untreated (k−), resulting in four experimental groups: D+/k+, D+/k−, D−/k+, and D−/k−. Rumen samples were collected from kids at weaning and 1 and 4 months after (3 and 6 months after birth) and from does at the end of the treating period (2 months). Pyrosequencing analyses showed a modified archaeal community composition colonizing the rumen of kids, although such effect did not persist entirely 4 months after; however, some less abundant groups remained different in treated and control animals. The different response on the archaeal community composition observed between offspring and adult goats suggests that the competition occurring in the developing rumen to occupy different niches offer potential for intervention.

Home-based management of cancer patients (CPs) experiencing toxicities while on anticancer treatment: The impact of a nurse-led telephone triage (NTT).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 2002-2002
Author(s):  
Lorenzo Calvetti ◽  
Marta Tealdo ◽  
Roberta Cimenton ◽  
Angela Gentile ◽  
Rachele Pretto ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Cost Savings ◽  
Successful Implementation ◽  
Chi Square ◽  
Early Management ◽  
Home Based ◽  
Anticancer Treatment ◽  
New Treatment ◽  
Grade 3 ◽  
The Impact

2002 Background: Novel organization models are needed to ensure early management of new treatment-related toxicity of anticancer treatments. Aim of this prospective observational study was to evaluate the impact of the introduction of NTT in reducing hospitalization of CPs. Methods: CPs on active medical treatment at the Department of Oncology of San Bortolo Hospital (Vicenza, Italy) were given instructions to refer to NTT in case of treatment-related adverse events (TRAEs). The service was opened Mon to Fri from 8am to 8pm. Assessment of TRAEs was performed by trained oncology nurses according to the CTCAE scale and subsequent actions were taken according to the severity of the events. The assessment was made under supervision of a medical oncologist in charge of the service while on duty. Primary endpoint of the study was to compare the rate of hospitalization of CPs on anticancer treatment after the introduction of NTT compared to 2017-2018 period. Results: From September 2018 to September 2019 1,075 patients received systemic anticancer treatment (versus 936 patients in the equivalent 2017 – 2018 period). Total consultations at NTT were 429; 581 TRAEs were reported. 117 patients reported more than one TRAE. CTCAE were graded as G1 237 (40.8%), G2 231 (39.8%) or G3-G4 113 (19.4%). The most common grade ≥ 3 TRAE was fever (38 events (33.6%) that resulted a febrile neutropenia in 7 cases) followed by cancer pain (15 (13.3%)) and fatigue (9 (8%)). In the observation period, 109 CPs on treatment were hospitalized versus 138 in the 2017-2018 period with a normalized hospitalization rate of 10.1% versus 14.7 % (p = 0.002, chi-square) with a reduction of normalized number of hospitalizations of 44 (estimated cost savings of 380.160 euros). Conclusions: Our results provided evidence of successful implementation of the NTT system in reducing rates of hospitalization through emergency room in cancer patients receiving modern medical treatments.

Home-Based Management of Patients With Cancer Experiencing Treatment-Induced Toxicities With a Nurse-Led Telephone Triage (the NTT Study)

2021 ◽  
pp. OP.21.00192
Author(s):  
Lorenzo Calvetti ◽  
Marta Tealdo ◽  
Francesca Simionato ◽  
Gaetana Pagiusco ◽  
Roberta Cimenton ◽  
...  
Keyword(s):  
Adverse Events ◽  
Cost Savings ◽  
Telephone Triage ◽  
Chi Square ◽  
Medical Treatments ◽  
Early Management ◽  
Patients With Cancer ◽  
Home Based ◽  
Anticancer Treatment ◽  
The Impact

PURPOSE: Novel organization models ensure early management of treatment-related adverse events (TRAEs) of new anticancer drugs. The aim of this prospective observational study was to evaluate the impact of the introduction of a nurse-led telephone triage (NTT) in reducing hospitalization of patients with cancer (CPs). PATIENTS AND METHODS: CPs on active medical treatment were educated to call the NTT in case of symptoms or TRAEs. Assessment of TRAEs was performed by trained oncology nurses according to the Common Terminology Criteria for Adverse Events grading scales and subsequent actions were taken according to the severity of the events. The primary end point of the study was to compare the rate of hospitalization of CPs on anticancer treatment after the introduction of NTT with that of the 2017-2018 period. RESULTS: From September 2018 to September 2019, a total of 1,075 patients received systemic anticancer treatment ( v 936 patients in the same 2017-2018 period). Total consultations at NTT were 429 and 581 TRAEs were reported. Notably, 117 patients reported more than one TRAE. Common Terminology Criteria for Adverse Events were graded as G1 (237, 40.8%), G2 (231, 39.8%), or G3-4 (113, 19.4%). In the observation period, 109 CPs on treatment were hospitalized versus 138 in the 2017-2018 period with a normalized hospitalization rate of 10.1% versus 14.7% ( P = .002 chi-square) with a reduction in normalized number of hospitalization of 44 and an estimated cost savings of 345,246 euros. CONCLUSION: The implementation of the NTT system in the clinical practice may help reducing the rates of hospitalization through the emergency room of CPs receiving modern medical treatments.

A prospective naturalistic study of the impact of an intensive medical treatment on the social behavior of child and adolescent cancer patients

1981 ◽  
Vol 2 (1) ◽  
pp. 29-47 ◽  
Author(s):  
Elizabeth J. Susman ◽  
Albert R. Hollenbeck ◽  
Ellen D. Nannis ◽  
Barbara E. Strope ◽  
Stephen P. Hersh ◽  
...  
Keyword(s):  
Social Behavior ◽  
Medical Treatment ◽  
Cancer Patients ◽  
Child And Adolescent ◽  
Naturalistic Study ◽  
Adolescent Cancer ◽  
The Social ◽  
The Impact

scholarly journals The Impact of COVID-19 Pandemic on Cancer Care in a Tertiary Care Facility

2021 ◽  
Vol 10 (01) ◽  
pp. 32-35
Author(s):  
Pradeep Kumar Reddy K. ◽  
Jyosthna Elagandula ◽  
Shivani Patel ◽  
Rajesh Patidar ◽  
Vikas Asati ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Active Treatment ◽  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
Care Facility ◽  
Cancer Type ◽  
Cancer Management ◽  
Tertiary Care Facility ◽  
Anticancer Treatment ◽  
The Impact

Abstract Background Coronavirus disease 2019 (COVID-19) pandemic had an overwhelming impact on health care worldwide. Cancer patients represent a subgroup that is vulnerable and is under high risk. It is, therefore, necessary to analyze factors that predict outcomes in these patients so that they can be triaged accordingly to mitigate the effects of COVID-19 on cancer management. To date, the impact of COVID-19 on cancer patients remain largely unknown. Methods Data of 291 cancer patients undergoing active treatment from March 23 to August 15, 2020 were retrospectively reviewed; the incidence, demographic and clinical characteristics, treatment, and outcomes of cancer patients infected by COVID-19 were included in the analysis. Discussion During the index period (March 23–August 15, 2020), 4,494 confirmed cases of COVID-19 were admitted at our institute. In the department of medical oncology out of 578 patients presented to outpatient department, 291 patients were admitted for active treatment. Considering the cancer patients, infection rate was 7.9% (23/291) and mortality 13% (3/23). Median age was 40 years and the majority of patients were male (60%). The most common cancer type was acute lymphoblastic leukemia presented at various stages of treatment. Twenty patients (86.9%) were discharged after full clinical recovery and negative real-time polymerase chain reaction on a nasopharyngeal swab. Anticancer treatment was modified according to the type of cancer under intensive surveillance. Conclusion Although mortality rate in COVID-19 cancer patients is elevated, our results support the feasibility and safety of continuing anticancer treatment during pandemic by endorsing consistent preventive measures, but however should be modified based on the type and prognosis of cancer.

Impact of COVID19 pandemic on the hospitalization burden of cancer patients: Results of a quasi-experimental study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13527-e13527
Author(s):  
Juan Cristobal Sanchez ◽  
Beatriz Nuñez García ◽  
Alberto Ruano ◽  
Mariola Blanco ◽  
Blanca Cantos Sanchez de Ibarguren ◽  
...  
Keyword(s):  
Experimental Study ◽  
Cancer Patients ◽  
Viral Pneumonia ◽  
University Hospital ◽  
Management Of Resources ◽  
Icd 10 ◽  
Quasi Experimental ◽  
Huge Impact ◽  
And Control ◽  
The Impact

e13527 Background: The SARS-CoV-2 (COVID19) pandemic has had a huge impact on health care, leading to the declaration of a “state of alarm” in many countries. This situation has possibly conditioned the care of cancer patients, compromising hospitalization resources due to healthcare restraints. We aim to analyze the impact of the COVID19 pandemic on the hospitalization of cancer patients during the “state of alarm” in an Academic Hospital in Madrid, considered one of the most affected regions in the World during the first wave of the pandemic in Europe. Methods: Quasi-experimental study with similar controls collected in the same period of the previous year from cancer patients admitted to the Medical Oncology (MO) department of the Puerta de Hierro University Hospital in Madrid. Patients were selected from diagnoses coded by the ICD-10 obtained from discharge reports in the Admission Department. Cancer and viral pneumonia codes (excluding influenza) were analyzed. Admission to Internal Medicine (IM) department was also explored to describe hospitalization due to COVID19 pneumonia. We defined two groups: pandemic (03/14/20 - 06/20/20) and control (pre-pandemic) (03/14/19 - 06/20/19). Results: 74 cancer patients were admitted to MO department in 2020, while 162 admissions were recorded for the equivalent period in 2019 (- 54%). No differences were observed related to sex and age. In 2020, emergency and programmed admissions decreased by the same proportion, and no difference in mortality was observed. Admissions for all neoplasms decreased, but with higher magnitude in breast cancer. Viral pneumonia (no influenza) in cancer patients were mostly admitted to IM (96%) rather than MO department. 79 cases were identified in 2020, 22 in 2019 (p < 0.001), with a non-significant increase in mortality in patients with pneumonia: 25,3% in 2020 and 13,6% in 2019. Conclusions: The COVID 19 pandemic seriously impacted cancer hospitalization care, decreasing admissions to the MO department in half compared to the equivalent period. We observed a reduction in admissions through all neoplasias. Admissions due to viral pneumonia in cancer patients increased 3.5 times, mostly admitted to IM changing the dynamics of cancer hospitalization burden and compromising resources. A non-significant increase in mortality from viral pneumonia was observed. The analysis of hospitalizations through administrative data can allow better management of resources and facilitate rapid decision-making in a pandemic situation yet to be resolved.[Table: see text]

scholarly journals 1648 Is Telephone Triage Here to Stay? An Audit of The Impact of COVID 19 On A Head and Neck Cancer Clinic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Osuji ◽  
V Srinivasan
Keyword(s):  
Cancer Patients ◽  
Neck Cancer ◽  
Medical Records ◽  
Treatment Initiation ◽  
District General Hospital ◽  
Telephone Triage ◽  
Significant Drop ◽  
Retrospective Audit ◽  
The Impact ◽  
Cancer Clinic

Abstract Due to the COVID19 pandemic, NHS reported a 60% drop in suspected cancer referrals and a delay in treatment initiation. In a pandemic, cancer waiting time (WT) targets can prove difficult to achieve. ENT UK and NHS England recommended a senior-led telephone triage system to be put in place in response to the pandemic. Aim of this audit was to assess the impact of the pandemic and evaluate the efficacy of tele-consults on the Head & Neck Cancer (H&N) Service at a District General Hospital. A retrospective audit of patients referred to the H&N clinic from April - June 2020, comparing patients managed by teleconsultations to patients seen F2F. Medical records were analysed to assess compliance with NHS Cancer WT targets. 2020 saw a 1.4% drop in referrals compared to 2019. Of the 224 referrals received from April - June 2020, 96.9% were seen within 14 days. 98.7% were initially reviewed by telephone, 37% of which were triaged to a F2F appointment, 39% were followed up by telephone and 24% were discharged or given routine appointments. 11.2% were diagnosed with cancer. Comparing cancer patients managed by telephone to patients seen F2F, 80% v 57% received a diagnosis by 28 days from the referral, and 100% v 17% started treatment by 62 days. The department did not have a significant drop in referrals due to the COVID pandemic. Cancer patients managed by telephone were more likely to start treatment within 62 days. Telephone consults should be a permanent feature of cancer clinics beyond the pandemic.

scholarly journals Possibilities of supportive therapy in patients with blood system tumors and malignant neoplasms

2020 ◽  
Vol 15 (3) ◽  
pp. 107-127
Author(s):  
V. B. Larionova ◽  
A. V. Snegovoy
Keyword(s):  
Supportive Care ◽  
Cancer Patients ◽  
Supportive Therapy ◽  
Scientific Data ◽  
The Body ◽  
Malignant Neoplasms ◽  
Russian Society ◽  
Prevention And Treatment ◽  
Anticancer Treatment ◽  
The Impact

Finding opportunities to improve treatment outcomes of cancer patients remains a difficult and unresolved problem. Modern anticancer treatment due to the intensity and molecular biological orientation allows achieving higher efficiency and theoretically reducing the complications frequency. At the same time, the “increase in efficiency” in the modern oncology really exists, but a “decrease in the incidence of complications” is far from its solution. In many ways, the problems of diagnosis, treatment and monitoring of complications are associated with the impact on complex physiological processes in the body of an oncological patient. Timely implementation of modern and adequate programs for the prevention and treatment of these complications defines the concept of “supportive therapy”, which provides at least half of the effectiveness of anticancer treatment.The Multinational Association of Supportive Care in Cancer (MASCC) was formed in 1990. The main tasks of the association were the creation of supportive care system, its popularization and accumulation of scientific data. The MASCC was used not only oncologists experience, but also of specialists working in almost all areas of medicine. Supportive therapy provides prevention and treatment of complications from the moment of malignant disease develops, at all stages of anticancer treatment, during the rehabilitation period, and in patients in the terminal phase.An important stage in the development of maintenance care in Russia was the holding of annual conferences in Moscow with the support of MASCC. Russia is included in the European MASCC group and in working group on supportive therapy and palliative care of the Chemotherapists Society (ESMO). The Russian Society of Supportive care in Oncology (RASSC) was organized In Russia on June 1, 2017. In recent years, the main directions of supportive care have been developed in our country. Today, supportive therapy is an obligatory component of anticancer programs, which allows the patient to cope with severe but potentially reversible disorders of vital organs at all stages of treatment. This is a real way to increase the treatment efficacy and improve the quality of life of cancer patients.

scholarly journals Pandemic-related impairment in the monitoring of patients with hypertension and diabetes and the development of a digital solution for the community health worker: quasi-experimental and implementation study (Preprint)

2021 ◽  
Author(s):  
Christiane Correa Rodrigues Cimini ◽  
Junia Xavier Maia ◽  
Magda Carvalho Pires ◽  
Leonardo Bonisson Ribeiro ◽  
Vânia Soares de Oliveira e Almeida Pinto ◽  
...  
Keyword(s):  
At Risk ◽  
Community Health ◽  
Health Workers ◽  
Uncontrolled Hypertension ◽  
Implementation Study ◽  
Significant Drop ◽  
Quasi Experimental ◽  
Patients At Risk ◽  
And Control ◽  
The Impact

BACKGROUND The restrictions imposed by the COVID-19 pandemic reduced the access of patients with chronic diseases to health services. The discontinuity of care is a cause of great concern, mainly in vulnerable regions. OBJECTIVE To assess the impact of the COVID-19 pandemic on the frequency of consultations and control of people with hypertension and diabetes (DM) and to develop and implement a digital solution to improve monitoring at home. METHODS This is a multi-methodological study. A quasi-experimental evaluation assessed the impact of the pandemic on the frequency of consultations and control of patients with hypertension and DM in 34 primary healthcare centers in 10 municipalities. Then, an implementation study developed an app with a decision support system (DSS) for community health workers (CHW) to identify and address patients with uncontrolled hypertension or DM at risk. An expert panel assessment evaluated feasibility, usability and utility of the software. RESULTS From 5070 patients, 4810 had hypertension (94.87%), 1371 had DM (27.4%) and 1111 (23.1%) had both diseases. There was a significant reduction in the weekly number of consultations (107 [IQR 60.0, 153.0] before vs 20.0 [IQR 7.0, 29.0] after social restriction, P<.001). Only 15.2% of all patients returned for consultation during the pandemic. Individuals with hypertension had lower systolic (120.0 [IQR 120.0-140.0] and diastolic blood pressure (80.0 [IQR 80.0-80]) than the ones that did not return (130.0 [IQR 120.0-140.0] and (80.0 [IQR 80.0-90.0]), P<.001. Also, those who returned had a higher proportion of controlled hypertension (64.3% vs 52.8%). For DM, there were no differences in glycohemoglobin levels. Concerning the DSS, the experts agreed that the CHWs can easily incorporate it into their routines and the app can identify patients at risk and improve the treatment. CONCLUSIONS The COVID-19 pandemic caused a significant drop in the number of consultations for patients with hypertension and DM in primary care. A DSS for CHW has proved to be feasible, useful and easily incorporated into their routines.

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