scholarly journals Measuring Catastrophic Costs Due to Tuberculosis in Myanmar

2021 ◽  
Vol 6 (3) ◽  
pp. 130
Author(s):  
Si Thu Aung ◽  
Aung Thu ◽  
Htin Lin Aung ◽  
Min Thu
Keyword(s):  
Household Income ◽  
Social Protection ◽  
Significant Proportion ◽  
Household Wealth ◽  
World Health ◽  
Cross Sectional Survey ◽  
Annual Household Income ◽  
Baseline Measure ◽  
Tb Treatment ◽  
Mdr Tb

Background: This is the first survey to use the World Health Organization (WHO) methodology to document the magnitude and main drivers of tuberculosis (TB) patient costs in order to guide policies on cost mitigation and to produce a baseline measure for the percentage of TB-affected households experiencing catastrophic costs in Myanmar. Methods: A nationally representative cross-sectional survey was administered to 1000 TB patients in health facilities from December 2015 to February 2016, focusing on costs of TB treatment (direct and indirect), household income, and coping strategies. A total cost was estimated for each household by extrapolating reported costs and comparing them to household income. If the proportion of total costs exceeded 20% of the annual household income, a TB-affected household was deemed to have faced catastrophic costs. Results: 60% of TB-affected households faced catastrophic costs in Myanmar. On average, total costs were USD 759, and the largest proportion of this total was accounted for by patient time (USD 365), followed by food costs (USD 200), and medical expenses (USD 130). Low household wealth quintile and undergoing MDR-TB treatment were both significant predictors for households facing catastrophic costs. Conclusions: The high proportion of TB-affected households experiencing catastrophic costs suggests the need for TB-specific social protection programs in patient-centered healthcare. The survey findings have led the government and donors to increase support for MDR-TB patients. The significant proportion of total spending attributable to lost income and food or nutritional supplements suggests that income replacement programs and/or food packages may ameliorate the burdensome costs.

scholarly journals Multi-source financing for tuberculosis treatment in China: key issues and challenges

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Qian Long ◽  
Wei-Xi Jiang ◽  
Hui Zhang ◽  
Jun Cheng ◽  
Sheng-Lan Tang ◽  
...  
Keyword(s):  
Local Government ◽  
Local Governments ◽  
Social Protection ◽  
Phase Iii ◽  
World Health ◽  
Chinese Government ◽  
Medical Assistance ◽  
Tb Treatment ◽  
Out Of Pocket Payments ◽  
Mdr Tb

Abstract Background The End Tuberculosis (TB) Strategy of the World Health Organization highlights the need for patient-centered care and social protection measures that alleviate the financial hardships faced by many TB patients. In China, TB treatments are paid for by earmarked government funds, social health insurance, medical assistance for the poor, and out-of-pocket payments from patients. As part of Phase III of the China-Gates TB project, this paper introduces multi-source financing of TB treatment in the three provinces of China and analyzes the challenges of moving towards universal coverage and its implications of multi-sectoral engagement for TB care. Main text The new financing policies for TB treatment in the three provinces include increased reimbursement for TB outpatient care, linkage of TB treatment with local poverty alleviation programs, and use of local government funds to cover some costs to reduce out-of-pocket expenses. However, there are several challenges in reducing the financial burdens faced by TB patients. First, medical costs must be contained by reducing the profit-maximizing behaviors of hospitals. Second, treatment for TB and multi-drug resistant TB (MDR-TB) is only available at county hospitals and city or provincial hospitals, respectively, and these hospitals have low reimbursement rates and high co-payments. Third, many patients with TB and MDR-TB are at the edge of poverty, and therefore ineligible for medical assistance, which targets extremely poor individuals. In addition, the local governments of less developed provinces often face fiscal difficulties, making it challenging to use of local government funds to provide financial support for TB patients. We suggest that stakeholders at multiple sectors should engage in transparent and responsive communications, coordinate policy developments, and integrate resources to improve the integration of social protection schemes. Conclusions The Chinese government is examining the establishment of multi-source financing for TB treatment by mobilization of funds from the government and social protection schemes. These efforts require strengthening the cooperation of multiple sectors and improving the accountability of different government agencies. All key stakeholders must take concrete actions in the near future to assure significant progress toward the goal of alleviating the financial burden faced by TB and MDR-TB patients. Graphic abstract

Multidisciplinary advisory teams to manage multidrug-resistant tuberculosis: the example of the French Consilium

2019 ◽  
Vol 23 (10) ◽  
pp. 1050-1054
Author(s):  
L. Guglielmetti ◽  
J. Jaffré ◽  
C. Bernard ◽  
F. Brossier ◽  
N. El Helali ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
New Drugs ◽  
World Health ◽  
Advisory Committees ◽  
Treatment Regimens ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Health Organization

SETTING: The World Health Organization (WHO) recommends that multidrug-resistant tuberculosis (MDR-TB) treatment should be managed in collaboration with multidisciplinary advisory committees (consilia). A formal national Consilium has been established in France since 2005 to provide a centralised advisory service for clinicians managing MDR-TB and extensively drug-resistant (XDR-TB) cases.OBJECTIVE: Review the activity of the French TB Consilium since its establishment.DESIGN: Retrospective description and analysis of the activity of the French TB Consilium.RESULTS: Between 2005 and 2016, 786 TB cases or contacts of TB cases were presented at the French TB Consilium, including respectively 42% and 79% of all the MDR-TB and XDR-TB cases notified in France during this period. Treatment regimens including bedaquiline and/or delamanid were recommended for 42% of the cases presented at the French TB Consilium since 2009. Patients were more likely to be presented at the French TB Consilium if they were born in the WHO Europe Region, had XDR-TB, were diagnosed in the Paris region, or had resistance to additional drugs than those defining XDR-TB.CONCLUSION: The French TB Consilium helped supervise appropriate management of MDR/XDR-TB cases and facilitated implementation of new drugs for MDR/XDR-TB treatment.

scholarly journals Households experiencing catastrophic costs due to tuberculosis in Uganda: magnitude and cost drivers

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Winters Muttamba ◽  
Racheal Tumwebaze ◽  
Levicatus Mugenyi ◽  
Charles Batte ◽  
Rogers Sekibira ◽  
...  
Keyword(s):  
Health Care ◽  
Social Protection ◽  
Medical Expenditure ◽  
Drug Resistant ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Cost Drivers ◽  
Assistance Programs ◽  
Free Health Care ◽  
Mdr Tb

Abstract Background Tuberculosis (TB) patients in Uganda incur large costs related to the illness, and while seeking and receiving health care. Such costs create access and adherence barriers which affect health outcomes and increase transmission of disease. The study ascertained the proportion of Ugandan TB affected households incurring catastrophic costs and the main cost drivers. Methods A cross-sectional survey with retrospective data collection and projections was conducted in 2017. A total of 1178 drug resistant (DR) TB (44) and drug sensitive (DS) TB patients (1134), 2 weeks into intensive or continuation phase of treatment were consecutively enrolled across 67 randomly selected TB treatment facilities. Results Of the 1178 respondents, 62.7% were male, 44.7% were aged 15–34 years and 55.5% were HIV positive. For each TB episode, patients on average incurred costs of USD 396 for a DS-TB episode and USD 3722 for a Multi drug resistant tuberculosis (MDR TB) episode. Up to 48.5% of households borrowed, used savings or sold assets to defray these costs. More than half (53.1%) of TB affected households experienced TB-related costs above 20% of their annual household expenditure, with the main cost drivers being non-medical expenditure such as travel, nutritional supplements and food. Conclusion Despite free health care in public health facilities, over half of Ugandan TB affected households experience catastrophic costs. Roll out of social protection interventions like TB assistance programs, insurance schemes, and enforcement of legislation related to social protection through multi-sectoral action plans with central NTP involvement would palliate these costs.

scholarly journals Understanding how geographic, demographic and treatment history impact health outcomes of patients with multi-drug-resistant tuberculosis in Pakistan, 2014–2017

2020 ◽  
Vol 148 ◽  
Author(s):  
F. Iqbal ◽  
M. K. Defer ◽  
A. Latif ◽  
H. Hadi
Keyword(s):  
Large Family ◽  
Multidrug Resistant ◽  
Incidence Rates ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
World Health ◽  
Sociocultural Factors ◽  
Second Line ◽  
Tb Treatment ◽  
Mdr Tb

Tuberculosis (TB) is one of the top 10 leading causes of morbidity and mortality worldwide [1]. In 2017, approximately 10 million people were infected with TB and 1.3 million patients faced mortality [1]. Patients with active TB can infect up to 10–15 people over a year. There is a greater risk of transmission in overcrowded areas with limited air ventilation including large family units, prisons and slums [1, 2]. Without proper diagnosis and treatment, roughly 45% of non-HIV positive TB patients face mortality [1]. With the help of global organizations and national TB treatment and control programmes, the global incidence of TB is declining by approximately 2% each year [1]. The World Health Organization (WHO) TB-strategy aims to end the TB epidemic and encourages partners to fund national TB programmes to improve diagnosis and treatment of TB. The goal is to ultimately decrease death rates by 90% and decrease incidence rates by 80% [1]. To achieve these goals, the decline in TB incidence needs to reach approximately 4–5% per year [1]. The WHO 2018 TB report identified multidrug resistant TB (MDR-TB) as the leading factor hindering that goal [1]. The incidence and spread of MDR-TB has drastically increased, where approximately 558 000 new cases of MDR-TB were diagnosed in 2017 causing more than 230 000 deaths globally [1]. MDR-TB is identified by resistance to the two most powerful anti-TB treatment drugs including isoniazid and rifampicin [3]. Patients with MDR-TB are required to start second-line anti-TB drugs (SLDs), which are limited, expensive, less effective and more toxic [1,2]. Therapy duration is one of the major limitations of second-line treatments, which may require up to two years of consistent use. Since TB affects mostly developing countries, long treatment durations and associated costs become a major challenge. In 2015, 15% of new TB cases were reported as MDR-TB, which drastically increased to 24% by 2017 [1]. Even with significant improvements in molecular tests and diagnostic methods, MDR-TB is still on the rise where the success rate of treatments is between 50 and 60% [1]. Additional characteristics including socioeconomic and sociocultural factors need to be considered when targeting and treating patients with MDR-TB.

scholarly journals Gambaran Kepatuhan Minum Obat Pada Pasien TB Paru : Literature Review

2021 ◽  
Vol 1 ◽  
pp. 1863-1874
Author(s):  
Pinaka Swasti Ratu Suryantari ◽  
I Irnawati
Keyword(s):  
Literature Review ◽  
Keyword Search ◽  
Pill Count ◽  
World Health ◽  
Drug Resistant ◽  
Pulmonary Tb ◽  
Tb Treatment ◽  
The World ◽  
Mdr Tb ◽  
Elementary School Education

AbstractCompliance in treatment and taking Anti Tuberculosis Drugs (OAT) in pulmonary TB Patients is very necessary for consistency in increasing the success rate of treatment. Pulmonary TB Treatment must be done regularly. Otherwise, resistance to Anti Tuberculosis Drugs (OAT) will occur, the duration of taking the drug will be longer, and there will be an increase in the dose consumed. Especially, it is about an adherence to take OAT in patients with Multy-Drug Resistant (MDR) TB and TB with HIV. To find out the description of medication adherence in pulmonary TB patients and and characteristics in pulmonary TB patients. This study used a literature review design. The pill count compliance measurement method was conducted through a keyword search and used 5 articles from Google Scholar, ProQuest, and PubMed published in 2017 – 2021. From the 5 articles reviewed, the results showed that most of the respondents were male (68% or 314 respondents). The education level of most of the respondents was elementary school education (34% or 105 respondents). Most of the respondents were employed (62% or 164 respondents). Compliance with taking medication in pulmonary TB patients was 322 (70%) compliant, given intervention was 159 (92%) compliant, without intervention was 163 (56%) compliant, MDR TB non-adherent was 105 (95%), and TB with HIV 135 was (86%) complied. Compliance with taking Anti Tuberculosis Drugs (OAT) in pulmonary TB patients must be continuously improved and maintained to achieve the World Health Organization's target of increasing the success of pulmonary TB treatment consistently at results of 90%.Keywords: Compliance, Taking Medicines, TB Drugs, Pill Count, and Pulmonary TB AbstrakKepatuhan dalam pengobatan dan minum Obat Anti Tuberkulosis (OAT) pada pasien TB Paru sangat diperlukan konsistensinya dalam meningkatkan angka keberhasilan pengobatan. Pengobatan TB Paru harus dilakukan secara teratur, jika tidak akan terjadi resistensi pada Obat Anti Tuberkulosis (OAT), semakin lama durasi minum obat dan terjadi peningkatan dosis yang dikonsumsi. Terutama kepatuhan minum OAT pada pasien TB Multy Drug Resistant (MDR) dan TB dengan HIV. Mengetahui gambaran kepatuhan minum obat pada pasien TB Paru dan karakteristik pada pasien TB Paru. Desain Literature Review dengan metode pengukuran kepatuhan pill count melakukan pencarian melalui kata kunci dan menggunakan 5 artikel dari database hasil penulusuran elektronik pada Google Cendekia, ProQuest, Pubmed yang dipublish pada tahun 2017 – 2021. Dari 5 artikel yang di review di dapatkan hasil responden pada artikel sebagian besar berjenis kelamin laki – laki yaitu 314 (68%). Tingkat pendidikan responden sebagian besar berpendidikan SD yaitu 105 (34%), dan sebagian besar responden bekerja yaitu 164 (62%). Kepatuhan minum obat pada pasein TB dengan mengabaikan intervensi yang diberikan yaitu 322 (70%) patuh, diberikan intervensi 159 (92%) patuh, tanpa intervensi yang diberikan 163 (56%) patuh, TB MDR tidak patuh 105 (95%), dan TB dengan HIV 135 (86%) patuh. Kepatuhan minum Obat Anti Tuberkulosis (OAT) pada pasien TB Paru harus terus ditingkatkan dan dipertahankan untuk mencapai target World Heatlh Organisation dalam meningkatkan keberhasilan pengobatan TB Paru secara konsisten pada hasil ≥ 90%.Kata kunci: Kepatuhan; Minum Obat; Obat TB; Pill Count; dan TB Paru

scholarly journals The role of active case finding in reducing patient incurred catastrophic costs for tuberculosis in Nepal

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Suman Chandra Gurung ◽  
Kritika Dixit ◽  
Bhola Rai ◽  
Maxine Caws ◽  
Puskar Raj Paudel ◽  
...  
Keyword(s):  
Social Protection ◽  
Case Finding ◽  
World Health ◽  
Active Case Finding ◽  
Annual Household Income ◽  
Chi Square ◽  
Active Case ◽  
Pre Treatment ◽  
Health Organization

Abstract Background The World Health Organization (WHO) End TB Strategy has established a milestone to reduce the number of tuberculosis (TB)- affected households facing catastrophic costs to zero by 2020. The role of active case finding (ACF) in reducing patient costs has not been determined globally. This study therefore aimed to compare costs incurred by TB patients diagnosed through ACF and passive case finding (PCF), and to determine the prevalence and intensity of patient-incurred catastrophic costs in Nepal. Methods The study was conducted in two districts of Nepal: Bardiya and Pyuthan (Province No. 5) between June and August 2018. One hundred patients were included in this study in a 1:1 ratio (PCF: ACF, 25 consecutive ACF and 25 consecutive PCF patients in each district). The WHO TB patient costing tool was applied to collect information from patients or a member of their family regarding indirect and direct medical and non-medical costs. Catastrophic costs were calculated based on the proportion of patients with total costs exceeding 20% of their annual household income. The intensity of catastrophic costs was calculated using the positive overshoot method. The chi-square and Wilcoxon-Mann-Whitney tests were used to compare proportions and costs. Meanwhile, the Mantel Haenszel test was performed to assess the association between catastrophic costs and type of diagnosis. Results Ninety-nine patients were interviewed (50 ACF and 49 PCF). Patients diagnosed through ACF incurred lower costs during the pre-treatment period (direct medical: USD 14 vs USD 32, P = 0.001; direct non-medical: USD 3 vs USD 10, P = 0.004; indirect, time loss: USD 4 vs USD 13, P <  0.001). The cost of the pre-treatment and intensive phases combined was also lower for direct medical (USD 15 vs USD 34, P = 0.002) and non-medical (USD 30 vs USD 54, P = 0.022) costs among ACF patients. The prevalence of catastrophic direct costs was lower for ACF patients for all thresholds. A lower intensity of catastrophic costs was also documented for ACF patients, although the difference was not statistically significant. Conclusions ACF can reduce patient-incurred costs substantially, contributing to the End TB Strategy target. Other synergistic policies, such as social protection, will also need to be implemented to reduce catastrophic costs to zero among TB-affected households.

scholarly journals Glycated hemoglobin screening identifies patients admitted for retreatment of tuberculosis at risk for diabetes in Tanzania

2016 ◽  
Vol 10 (04) ◽  
pp. 423-426 ◽  
Author(s):  
Margaretha L. Sariko ◽  
Stellah G. Mpagama ◽  
Jean Gratz ◽  
Riziki Kisonga ◽  
Queen Saidi ◽  
...  
Keyword(s):  
Glycated Hemoglobin ◽  
Multidrug Resistant ◽  
Referral Hospital ◽  
World Health ◽  
Tb Treatment ◽  
Number Needed To Screen ◽  
Resource Limited ◽  
Northern Tanzania ◽  
Mdr Tb ◽  
Health Organization

Introduction: World Health Organization recommendations of bidirectional screening for tuberculosis (TB) and diabetes have been met with varying levels of uptake by national TB programs in resource-limited settings. Methodology: Kibong’oto Infectious Diseases Hospital (KIDH) is a referral hospital for TB from northern Tanzania, and the national referral hospital for multidrug-resistant (MDR)-TB. Glycated hemoglobin (HgbA1c) testing was done on patients admitted to KIDH for newly diagnosed TB, retreatment TB, and MDR-TB, to determine the point prevalence of diabetes (HgbA1c ≥ 6.5%) and prediabetes (HgbA1c 5.7%–6.4%). Results: Of 148 patients hospitalized at KIDH over a single week, 59 (38%) had no prior TB treatment, 22 (15%) were retreatment cases, and 69 (47%) had MDR-TB. Only 3 (2%) had a known history of diabetes. A total of 144 (97%) had successful screening, of which 110 (77%) had an HgbA1c ≤ 5.6%, 28 (19%) had ≥ 5.7 < 6.5, and 6 (4%) had ≥ 6.5. Comparing subjects with prediabetes or diabetes to those with normal A1c levels, retreatment patients were significantly more likely to have a A1c ≥ 5.7% (odds ratio: 3.2, 95% CI: 1.2–9.0; p = 0.02) compared to those without prior TB treatment. No retreatment case was a known diabetic, thus the number needed to screen to diagnose one new case of diabetes among retreatment cases was 11. Conclusions: Diabetes prevalence by HgbA1c was less common than expected, but higher HgA1c values were significantly more frequent among retreatment cases, allowing for a rational, resource-conscious screening approach.

scholarly journals Risk Factors for Mortality Among Patients Diagnosed With Multi-Drug Resistant Tuberculosis In Uganda- A Case-Control Study

2020 ◽  
Author(s):  
Enock Kizito ◽  
Joseph Musaazi ◽  
Kenneth Mutesasira ◽  
Fred Twinomugisha ◽  
Helen Namwanje ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
World Health ◽  
Incidence Density ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
Control Study

Abstract Background:The World Health Organization (WHO) End TB strategy aims to reduce mortality due to tuberculosis (TB) to less than 5% by 2035. However, mortality due to multidrug-resistant tuberculosis (MDR-TB) is particularly high and stood at 15% globally in 2018. In Uganda, MDR-TB associated mortality was 19% in the same year. We set out to examine the risk factors for mortality among a cohort of patients diagnosed with MDR-TB in Uganda.Methods:We conducted a case-control study nested within the national MDR-TB cohort. We defined cases as patient who died from any cause during the two years following treatment initiation. We selected two controls for each case from patients alive and on MDR-TB treatment at the time that the death occurred (incidence-density sampling) and matched the cases and controls on health facility at which they were receiving care. We performed conditional logistic regression to identify the risk factors for mortality. Results:Data from 198 patients (66 cases and 132 controls) started on TB from January 1 to December 31, 2016, was analyzed for this study. Majority of patients (60.6%) were male and were HIV positive (59.6%). About half (46.0%) were aged 19-34 years. On multiple regression analysis, co-infection with HIV (aOR 1.9, 95% CI [1.1-4.92]p=0.05); non-adherence to TB treatment (aOR 1.92, 95% CI [1.02-4.83] p=0.04); age over 50 years (aOR 3.04, 95% CI [1.13-8.20] p=0.03); and not having any education (aOR 3.61, 95% CI [1.1-10.4] p=0.03) were associated with MDR TB mortality. Conclusion: To improve MDR-TB treatment outcomes, to attention must be paid to provision of social support particularly for older persons on MDR TB treatment. Interventions that support treatment adherence and promote early detection of HIV infection should also be emphasized for all persons diagnosed with TB.

scholarly journals Factors associated with drinking behaviour during COVID-19 social distancing and lockdown among adults in the UK

2020 ◽  
Author(s):  
Claire Garnett ◽  
Sarah E Jackson ◽  
Melissa Oldham ◽  
Jamie Brown ◽  
Andrew Steptoe ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Household Income ◽  
Drinking Behaviour ◽  
Cross Sectional Survey ◽  
Annual Household Income ◽  
The Past ◽  
The Uk ◽  
Seriously Ill ◽  
Protective Behaviours ◽  
Key Worker

Abstract Aim: To assess what factors were associated with reported changes to usual alcohol drinking behaviour during the start of lockdown in the UK. Design: Online cross-sectional survey from 21st March to 4th April 2020. Setting: UK. Participants: 30,375 adults aged ≥18y. Measurements: Changes in drinking over the past week, sociodemographic characteristics, diagnosed or suspected COVID-19, adherence to COVID-19 protective behaviours, stress about COVID-19, finances or boredom, recent drop in household income, key worker status, and health conditions. Findings: Of 22,113 drinkers (65.7% of analytic sample), 48.1% (95% CI=47.0-49.1%) reported drinking about the same as usual, 25.7% (24.8-26.6%) reported drinking less than usual, and 26.2% (25.4-27.1%) reported drinking more than usual over the past week. Drinking less than usual was independently associated with being younger (OR=0.88 [95% CI=0.83-0.93]), male (OR=0.76 [0.68-0.84]), of an ethnic minority (OR=0.76 [0.61-0.97]), low annual household income (OR=0.74 [0.66-0.83]), having diagnosed or suspected COVID-19 (OR=2.04 [1.72-2.41]), adhering to COVID-19 protective behaviours (OR=1.58 [1.08-2.32]), being significantly stressed about becoming seriously ill from COVID-19 (OR=1.26 [1.08-1.48]) and not being a key worker (OR=0.87 [0.76-0.99]). Drinking more than usual was independently associated with being younger (OR=0.73 [0.69-0.78]), female (OR=1.36 [1.22-1.51]), post-16 qualifications (OR=1.21 [1.04-1.40]), high annual household income (OR=1.43 [1.27-1.61]), being significantly stressed about catching (OR=1.22 [1.03-1.45]) or becoming seriously ill from COVID-19 (OR=1.28 [1.10-1.48]), being significantly stressed about finances (OR=1.43 [1.24-1.66]), and having a diagnosed anxiety disorder (OR=1.24 [1.05-1.46]). Conclusions: In a representative sample of adults in the UK, about half of drinkers reported drinking the same amount of alcohol as usual during the start of the COVID-19 related lockdown, with a quarter drinking more and a quarter drinking less than usual. Drinking more than usual was associated with being younger, female, high socioeconomic position, having an anxiety disorder, and being stressed about finances or COVID-19. These groups may benefit targeted alcohol reduction support if there are further periods of lockdown.

Assessing the impact of the COVID-19 pandemic on patients with genitourinary malignancies.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 38-38
Author(s):  
Hala Borno ◽  
Sylvia Zhang ◽  
Scarlett Lin Gomez ◽  
Celia Kaplan ◽  
Christine Miaskowski ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Household Income ◽  
Negative Impact ◽  
Survey Study ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Cross Sectional Survey ◽  
Annual Household Income ◽  
Ongoing Research ◽  
The Impact

38 Background: The COVID-19 pandemic has vast implications on the health system. Patients with a cancer diagnosis may face greater challenges in the context of the current COVID-19 pandemic. Methods: We sought to assess the impact of the COVID-19 pandemic among patients with genitourinary malignancies. We performed a cross-sectional survey study at a Comprehensive Cancer Center during the current pandemic. Results: A total of 86 participants were recruited to the study to date, 72.1% had prostate, 19.8% had kidney, and 12.8% had bladder cancer. A subset (n = 5) had more than one primary tumor. The mean time from diagnosis was 6.47 years (std dev 6.01, range from 0 to 27 years). Overall, 73% reported having metastatic disease and prior treatment with surgery (62%), radiation (71%), or systemic therapy (68%), with 68.6% currently receiving cancer treatment. In the study, 78.9% of patients were >65 years of age and 88.2% were White. The majority of participants had a bachelor’s degree or higher level of education (74.4%), were legally married (82.6%), were homeowners (91.9%), and reported an annual household income of >$100,000 (56.0%). Among respondents, 7% reported loss/change of health insurance and 30% reported a decrease in household income. Among patients with reduced household income, 23% reported a reduction of more than 50%. In this study, 28% of patients reported that the pandemic impacted their cancer treatment. Overall 7% reported decrease in frequency of labs, 11% reported a delay in obtaining a scan, 5% reported treatment delays, and 96% reported use of telemedicine (video or telephone) visit. Overall, 59% reported fear of hospitalization, 23% reported delays in seeking medical care, and 16% reported missing required medications. Conclusions: The negative impact of the COVID-19 pandemic on patients with genitourinary malignancies is extensive. Ongoing research is evaluating the impact across socio-demographically groups and examine clinical outcomes associated with delays in care and medication non-adherence.

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