Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 28, 2020
Date Accepted: Jun 4, 2020
Date Submitted to PubMed: Jun 5, 2020
Virtual Management of Cancer Patients in the Era of COVID-19 Pandemic
ABSTRACT
Background:
During COVID-19 pandemic, patients from distant geographical areas will be affected the most. Virtual management “telemedicine” has been shown to reduce health costs and improve access to care.
Objective:
The aim of this survey is to report the views of oncologists on virtual management (VM) “awareness, challenges, preferences” and priority of prescribing anti-cancer treatments during the COVID-19 pandemic.
Methods:
We created self-administrated electronic survey about VM of cancer patients during COVID-19 pandemic. We evaluated the clinical sensibility and pilot tested the instrument. We surveyed practicing oncologists using snowball sampling in the Gulf and Arab countries via emails, social media networks and sent reminders one and two weeks later using SurveyMonkey.
Results:
We received 222 responses from validated respondents from April 2-April 22, 2020. Awareness of the virtual clinics, virtual multidisciplinary teams (MDT) and virtual prescriptions encountered in 82%, 79% and 75%, respectively. VM challenges were lack of physical exam in 60%, patient’s awareness & access in 59%, lack of physical attendance of patients in 42%, IT support in 37% and safety of VM in 35%. 50% and 48% of oncologists did not prefer virtual prescription of chemotherapy and novel immunotherapy respectively, however, 85%, 74% and 57% preferred virtual prescription of hormonal, bone modifying agents and targeted therapy respectively Oncologists preferred to continue neoadjuvant, adjuvant & perioperative treatments in 83%, 83%, 80% respectively. 53% preferred to continue 1st line palliative treatment, in contrast to 20% and 30% preferred to interrupt 2nd and 3rd line palliative treatment respectively. All responders preferred oral route and 53% preferred subcutaneous (SC) route. In contrast, 87% did not prefer intravenous (IV) route. Forty six percent of oncologists responded “definitely” prefer to manage cancer patients virtually,
Conclusions:
Oncologists have high level of awareness about VM. While 2nd and 3rd line palliative treatments should be interrupted, treatments in neoadjuvant, adjuvant, peri-operative and 1st line palliative should continue. Our results confirm that oncologists’ views on priority of anti-cancer treatments are consistent with evolving literature during COVID-19 pandemic. Challenges to VM should be addressed to improve the care of cancer patients.
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