Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH, USA.
Department of Medical Oncology, The Ohio State University, Columbus, OH, USA.
J Cancer Surviv. 2023 Dec;17(6):1708-1714. doi: 10.1007/s11764-022-01231-x. Epub 2022 Jul 27.
All Commission on Cancer-accredited comprehensive cancer centers offer survivorship programs (SPs) to women upon completion of treatment. These SPs can include clinical and non-clinical programming such as physical rehabilitation, emotional and psychosocial support, nutrition, and exercise programming. Concern about the availability and access to these programs during the COVID-19 pandemic has been described in recent literature. We sought to identify the impact of the COVID-19 pandemic on participation in these supportive services for breast cancer patients within a single institution.
The Ohio State University tertiary care center offers clinical and non-clinical breast cancer support services. Descriptive statistics were utilized to summarize referral and patient participation data from January 2019 through July 2021. Data from calendar year 2019 was used as a normative comparison for pre-COVID-19. In-person and telehealth use was tracked longitudinally.
During the lockdown due to the COVID-19 pandemic (March through May 2020), provider referrals to SPs declined by 10%, while the overall total for the calendar year modestly increased from 1195 in 2019 to 1210 in 2020, representing a 1.3% increase. Psycho-oncology referrals increased from 280 to 318 (13.5%). The most significant change of participation rates in non-clinical SPs during the pandemic was utilization of exercise content, which increased by 220% from 2019 to 2020. The total proportion of breast cancer participants choosing an exercise program increased from 16.8% in 2019 to 42.2% in 2021, making it the most selected program area overall. Previously, nutrition was the most selected program area as it comprised 42.5% of overall utilization in 2019.
The pandemic's potential to place barriers to participation in SPs is a legitimate concern. We found a modest decline in provider referrals to clinical services during the lockdown period, while patient-directed participation increased with more survivors engaging in exercise-based programs. Transitioning to virtual platforms served to maintain access for patients.
As we grapple with the COVID-19 pandemic, patients with cancer deserve increased attention due to the expected stressors associated with the diagnosis. Those in the survivorship stage utilize services for psychosocial support, and the observed increase in utilization of SPs suggests an elevated need for connectivity. To meet this need, telehealth platforms have been expanded to allow for continued participation. It remains to be seen whether this will be sustained post-COVID-19 or whether reduced human contact will create new needs for programming.
所有获得癌症委员会认证的综合性癌症中心在患者完成治疗后都会为其提供生存项目 (SP)。这些 SP 可以包括临床和非临床项目，如身体康复、情感和心理社会支持、营养和锻炼项目。最近的文献中描述了人们对在 COVID-19 大流行期间这些项目的可用性和可及性的担忧。我们试图确定 COVID-19 大流行对单一机构内乳腺癌患者参与这些支持服务的影响。
俄亥俄州立大学的三级护理中心提供临床和非临床的乳腺癌支持服务。描述性统计用于总结 2019 年 1 月至 2021 年 7 月的转诊和患者参与数据。将 2019 年的数据用作 COVID-19 之前的规范比较。纵向跟踪了面对面和远程医疗的使用情况。
在 COVID-19 大流行（2020 年 3 月至 5 月）封锁期间，提供者向 SP 的转诊减少了 10%，而这一年的总数略有增加，从 2019 年的 1195 人增加到 2020 年的 1210 人，增长了 1.3%。心理肿瘤学转诊从 280 人增加到 318 人（增加了 13.5%）。在大流行期间，非临床 SP 参与率的最大变化是锻炼内容的利用率增加了 220%，从 2019 年的 2019 年增加到 2020 年的 2019 年。选择锻炼计划的乳腺癌患者总数从 2019 年的 16.8%增加到 2021 年的 42.2%，成为总体上最受欢迎的项目领域。此前，营养是最受欢迎的项目领域，因为它占 2019 年总利用率的 42.5%。
大流行可能会对参与 SP 造成障碍，这是一个合理的担忧。我们发现，在封锁期间，向临床服务提供者的转诊略有下降，而患者导向的参与度增加，更多的幸存者参与了基于锻炼的项目。转向虚拟平台有助于为患者提供服务。
随着我们应对 COVID-19 大流行，由于与诊断相关的预期压力，癌症患者应得到更多关注。处于生存阶段的患者利用心理社会支持服务，观察到 SP 使用量的增加表明对联系的需求增加。为了满足这一需求，已经扩大了远程医疗平台以允许继续参与。尚不清楚这是否会在 COVID-19 之后持续，或者减少人际接触是否会产生对编程的新需求。
