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      Multicenter evaluation of breast cancer patients’ satisfaction and experience with oncology telemedicine visits during the COVID-19 pandemic

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          Abstracts

          Introduction

          During the COVID-19 pandemic, teleconsultation was implemented in clinical practice to limit patient exposure to COVID-19 while monitoring their treatment and follow-up. We sought to examine the satisfaction of patients with breast cancer (BC) who underwent teleconsultations during this period.

          Methods

          Eighteen centres in France and Italy invited patients with BC who had at least one teleconsultation during the first wave of the COVID-19 pandemic to participate in a web-based survey that evaluated their satisfaction (EORTC OUT-PATSAT 35 and Telemedicine Satisfaction Questionnaire [TSQ] scores) with teleconsultation.

          Results

          Among the 1299 participants eligible for this analysis, 53% of participants were undergoing standard post-treatment follow-up while 22 and 17% were currently receiving active anticancer therapy for metastatic and localised cancers, respectively. The mean satisfaction scores were 77.4 and 73.3 for the EORTC OUT-PATSAT 35 and TSQ scores, respectively. In all, 52.6% of participants had low/no anxiety. Multivariable analysis showed that the EORTC OUT-PATSAT 35 score correlated to age, anxiety score and teleconsultation modality. The TSQ score correlated to disease status and anxiety score.

          Conclusion

          Patients with BC were satisfied with oncology teleconsultations during the COVID-19 pandemic. Teleconsultation may be an acceptable alternative follow-up modality in specific circumstances.

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          Most cited references40

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          The validity of the Hospital Anxiety and Depression Scale

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            Is Open Access

            A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 ( COVID ‐19) Pandemic: An International Collaborative Group

            Abstract The outbreak of coronavirus disease 2019 (COVID‐19) has rapidly spread globally since being identified as a public health emergency of major international concern and has now been declared a pandemic by the World Health Organization (WHO). In December 2019, an outbreak of atypical pneumonia, known as COVID‐19, was identified in Wuhan, China. The newly identified zoonotic coronavirus, severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), is characterized by rapid human‐to‐human transmission. Many cancer patients frequently visit the hospital for treatment and disease surveillance. They may be immunocompromised due to the underlying malignancy or anticancer therapy and are at higher risk of developing infections. Several factors increase the risk of infection, and cancer patients commonly have multiple risk factors. Cancer patients appear to have an estimated twofold increased risk of contracting SARS‐CoV‐2 than the general population. With the WHO declaring the novel coronavirus outbreak a pandemic, there is an urgent need to address the impact of such a pandemic on cancer patients. This include changes to resource allocation, clinical care, and the consent process during a pandemic. Currently and due to limited data, there are no international guidelines to address the management of cancer patients in any infectious pandemic. In this review, the potential challenges associated with managing cancer patients during the COVID‐19 infection pandemic will be addressed, with suggestions of some practical approaches. Implications for Practice The main management strategies for treating cancer patients during the COVID‐19 epidemic include clear communication and education about hand hygiene, infection control measures, high‐risk exposure, and the signs and symptoms of COVID‐19. Consideration of risk and benefit for active intervention in the cancer population must be individualized. Postponing elective surgery or adjuvant chemotherapy for cancer patients with low risk of progression should be considered on a case‐by‐case basis. Minimizing outpatient visits can help to mitigate exposure and possible further transmission. Telemedicine may be used to support patients to minimize number of visits and risk of exposure. More research is needed to better understand SARS‐CoV‐2 virology and epidemiology.
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              Impact of COVID-19 on Cancer Care: How the Pandemic Is Delaying Cancer Diagnosis and Treatment for American Seniors

              PURPOSE While the immediate care and access disruptions associated with the COVID-19 pandemic have received growing attention in certain areas, the full range of gaps in cancer screenings and treatment is not yet well understood or well documented throughout the country comprehensively. METHODS This study used a large medical claims clearinghouse database representing 5%-7% of the Medicare fee-for-service population to characterize changes in the utilization of cancer care services and gain insight into the impact of COVID-19 on the US cancer population, including identification of new patients, gaps in access to care, and disruption of treatment journeys. RESULTS In March-July 2020, in comparison with the baseline period of March-July 2019, there is a substantial decrease in cancer screenings, visits, therapy, and surgeries, with variation by cancer type and site of service. At the peak of the pandemic in April, screenings for breast, colon, prostate, and lung cancers were lower by 85%, 75%, 74%, and 56%, respectively. Significant utilization reductions were observed in April for hospital outpatient evaluation and management (E&M) visits (−74%), new patient E&M visits (−70%), and established patient E&M visits (−60%). A decrease in billing frequency was observed for the top physician-administered oncology products, dropping in both April (−26%) and July (−31%). Mastectomies were reduced consistently in April through July, with colectomies similarly reduced in April and May and prostatectomies dipping in April and July. CONCLUSION The current impact of the COVID-19 pandemic on cancer care in the United States has resulted in decreases and delays in identifying new cancers and delivery of treatment. These problems, if unmitigated, will increase cancer morbidity and mortality for years to come.
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                Author and article information

                Contributors
                barbara.pistilli@gustaveroussy.fr
                Journal
                Br J Cancer
                Br J Cancer
                British Journal of Cancer
                Nature Publishing Group UK (London )
                0007-0920
                1532-1827
                29 September 2021
                : 1-8
                Affiliations
                [1 ]GRID grid.14925.3b, ISNI 0000 0001 2284 9388, Medical Oncology Department, , Gustave Roussy, ; Villejui, France
                [2 ]GRID grid.460789.4, ISNI 0000 0004 4910 6535, Department of Biostatistics and Epidemiology, Gustave Roussy, , University Paris-Saclay, ; Villejuif, France
                [3 ]GRID grid.7429.8, ISNI 0000000121866389, Oncostat U1018, Inserm, University Paris-Saclay, , Labeled Ligue Contre le Cancer, ; Villejuif, France
                [4 ]GRID grid.418116.b, ISNI 0000 0001 0200 3174, Medical Oncology Department, , Centre Léon Bérard, ; Lyon, France
                [5 ]GRID grid.418189.d, ISNI 0000 0001 2175 1768, Institut Normand du Sein, , Centre Francois Baclesse, ; Caen, France
                [6 ]GRID grid.452351.4, ISNI 0000 0001 0131 6312, Centre Oscar Lambret, ; Lille, France
                [7 ]GRID grid.50550.35, ISNI 0000 0001 2175 4109, Breast and Gynecologic Surgery, , Assistance Publique - Hopitaux De Paris, ; Paris, France
                [8 ]GRID grid.412212.6, ISNI 0000 0001 1481 5225, Medical Oncology Department, , CHU Limoges - Hopital Dupuytren, ; Limoges, France
                [9 ]Medical Oncology Department, Clinique Chenieux, Limoges, France
                [10 ]GRID grid.413695.c, ISNI 0000 0001 2201 521X, Breast Cancer Unit, , American Hospital of Paris, ; Neuilly-Sur-Seine, France
                [11 ]GRID grid.413328.f, ISNI 0000 0001 2300 6614, Breast Cancer Unit, , AP university Hospital St Louis, ; Paris, France
                [12 ]GRID grid.482015.a, Medical Oncology Department, , Institut Ste Catherine, ; Avignon, France
                [13 ]GRID grid.418191.4, ISNI 0000 0000 9437 3027, Medical Oncology Department, , ICO - Institut de Cancérologie de l’Ouest Nantes-Angers, ; Angers, France
                [14 ]GRID grid.417988.b, ISNI 0000 0000 9503 7068, Medical Oncology Department, , Centre Eugene - Marquis, ; Rennes, France
                [15 ]GRID grid.508487.6, ISNI 0000 0004 7885 7602, Medical Oncology Department, Institut Curie & St Cloud, , Université de Paris, ; Paris, France
                [16 ]GRID grid.418189.d, ISNI 0000 0001 2175 1768, Medical Oncology Department, , Centre Paul Strauss Centre de Lutte contre le Cancer, ; Strasbourg, France
                [17 ]GRID grid.418037.9, ISNI 0000 0004 0641 1257, Medical Oncology Department, , Centre Georges-François Leclerc (Dijon), ; Dijon, France
                [18 ]GRID grid.121334.6, ISNI 0000 0001 2097 0141, Department of Medical Oncology, Institut du Cancer de Montpellier, , Montpellier University, INSERM, ; U1194 Montpellier, France
                [19 ]GRID grid.413483.9, ISNI 0000 0001 2259 4338, Medical Oncology Department, , Hopital Tenon, ; Paris, France
                [20 ]GRID grid.14925.3b, ISNI 0000 0001 2284 9388, Patient Relationship Coordination, , Gustave Roussy, ; Villejuif, France
                [21 ]GRID grid.410345.7, ISNI 0000 0004 1756 7871, Medical Oncology Department, , IRCCS Ospedale Policlinico San Martino, ; Genova, Italy
                [22 ]GRID grid.5606.5, ISNI 0000 0001 2151 3065, Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, , University of Genova, ; Genova, Italy
                Author information
                http://orcid.org/0000-0002-7906-0991
                http://orcid.org/0000-0002-2863-9995
                http://orcid.org/0000-0001-7834-061X
                http://orcid.org/0000-0003-2106-9165
                http://orcid.org/0000-0003-1797-5296
                http://orcid.org/0000-0002-9184-7199
                Article
                1555
                10.1038/s41416-021-01555-y
                8480754
                34588616
                d66ae9a8-08c5-4559-9ae0-d1b9d2fa01f9
                © The Author(s), under exclusive licence to Springer Nature Limited 2021

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 29 May 2021
                : 31 August 2021
                : 17 September 2021
                Categories
                Article

                Oncology & Radiotherapy
                breast cancer,cancer
                Oncology & Radiotherapy
                breast cancer, cancer

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