Impact of COVID-19 on cancer service delivery: results from an international survey of oncology clinicians

ESMO Open

article

Grace Chazan¹  Fanny Franchini²  Marliese Alexander¹  Susana Banerjee⁵  Linda Mileshkin¹  Prunella Blinman⁸  Rob Zielinski^1,10  Deme Karikios^1,12  Nick Pavlakis^1,14  Solange Peters^1,15  Florian Lordick^1,16  David Ball¹  Gavin Wright^1,19  Maarten I. Jzerman²  Benjamin Solomon¹ 

[1] Sir Peter MacCallum Department of Oncology, University of Melbourne Victorian Comprehensive Cancer Centre;Centre for Cancer Research, University of Melbourne;Centre for Health Policy, University of Melbourne;Pharmacy Department, Peter MacCallum Cancer Centre;Gynaecology Unit, The Royal Marsden NHS Foundation Trust;Division of Clinical Studies, The Institute of Cancer Research;Department of Medical Oncology, Peter MacCallum Cancer Centre;Faculty of Medicine, The University of Sydney;Department of Medical Oncology, Concord Repatriation General Hospital;School of Medicine, Western Sydney University;Department of Medical Oncology, Orange Base Hospital;Department of Medical Oncology, Nepean Hospital;Nepean Clinical School, The University of Sydney;Department of Medical Oncology, Royal North Shore Hospital;Department of Oncology, Lausanne University Hospital CHUV;Department of Institut Roi Albert II, University Cancer Centre Leipzig;Department of Oncology, Leipzig University Medical Center;Department of Radiation Oncology, Peter MacCallum Cancer Centre;Department of Surgery, Peter MacCallum Cancer Centre;Department of Surgery, University of Melbourne

关键词: COVID-19;    oncology;    service delivery;   

DOI  :  10.1136/esmoopen-2020-001090

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Objectives To report clinician-perceived changes to cancer service delivery in response to COVID-19.Design Multidisciplinary Australasian cancer clinician survey in collaboration with the European Society of Medical Oncology.Setting Between May and June 2020 clinicians from 70 countries were surveyed; majority from Europe (n=196; 39%) with 1846 COVID-19 cases per million people, Australia (AUS)/New Zealand (NZ) (n=188; 38%) with 267/236 per million and Asia (n=75; 15%) with 121 per million at time of survey distribution.Participants Medical oncologists (n=372; 74%), radiation oncologists (n=91; 18%) and surgical oncologists (n=38; 8%).Results Eighty-nine per cent of clinicians reported altering clinical practices; more commonly among those with versus without patients diagnosed with COVID-19 (n=142; 93% vs n=225; 86%, p=0.03) but regardless of community transmission levels (p=0.26). More European clinicians (n=111; 66.1%) had treated patients diagnosed with COVID-19 compared with Asia (n=20; 27.8%) and AUS/NZ (n=8; 4.8%), p<0.001. Many clinicians (n=307; 71.4%) reported concerns that reduced access to standard treatments during the pandemic would negatively impact patient survival. The reported proportion of consultations using telehealth increased by 7.7-fold, with 25.1% (n=108) of clinicians concerned that patient survival would be worse due to this increase. Clinicians reviewed a median of 10 fewer outpatients/week (including non-face to face) compared with prior to the pandemic, translating to 5010 fewer specialist oncology visits per week among the surveyed group. Mental health was negatively impacted for 52.6% (n=190) of clinicians.Conclusion Clinicians reported widespread changes to oncology services, in regions of both high and low COVID-19 case numbers. Clinician concerns of potential negative impacts on patient outcomes warrant objective assessment, with system and policy implications for healthcare delivery at large.

【 授权许可】

CC BY|CC BY-NC-ND