ABSTRACT
Background: After the government declared a health emergency due to COVID-19 on March, 2020, the Mastology Teaching Unit (UDAM) providing care to breast cancer patients tried to ensure adequate oncological care, and to protect patients from the virus infection and serious complications due to a possible state of immunosuppression. Towards this objective, the Department of Clinical Oncology developed guidelines with some treatment modifications. Objective: To assess the health care activities of the UDAM during the period considered as the “peak” of the pandemic, since its beginning to June 30, 2020. Methods: This is an observational study that collected data from the electronic clinical record system called Oncology Electronic Health Record (HCEO) during the aforementioned period. Results: There werea total of 293 medical appointments (221 in person), through which 131 patients were attended to. The number of medical appointments decreased by 16.7% compared to the same period in 2019 (352 appointments). Of the patients who were attended to during the “peak” period, 109 (83.2%) were on systemic onco-specific treatment and 22 (16.8%) were attended to for disease control. The medical appointments were scheduled to evaluate the continuity of treatment and treatment modifications if necessary (95 patients;72.5%), for disease control (17;12.9%), for first-time consultation (12;9.1%) and to assess paraclinical studies (7;5.3%). The patients were on hormone therapy (HT) (81 patients;74%), chemotherapy (CT) (21;19%), and anti-HER2 therapies (9;8%). A total of 20 treatments were initiated, 14 with HT and 6 with CT. Of the 21 patients on CT, 14 (66.6%) were on adjuvant/neoadjuvant therapy. Of these, 9 (64.3%) continued with the same regimen with the addition of prophylactic granulocyte colony stimulating factors (G-CSF), and 5 (35.7%), who were receiving weekly paclitaxel, continued the treatment with no changes. The remaining 7 of 21 patients (33.3%) were on palliative CT. Of these, 2 (28.5%) continued the treatment with the addition of G-CSF, 3 (42.8%) continued with weekly capecitabine or paclitaxel with no treatment changes, and 2 (28.5%) changed their treatment regimen (a less myelosuppressive regimen was selected for one of them and this decision was due to the progression of the disease in the other patient). The 90 patients who were receiving adjuvant, neoadjuvant, or palliative criteria HT and/or anti-HER2 therapies, continued the treatment with no changes Conclusions: Although these are preliminary results, the available evidence suggests that, although medical appointments decreased by approximately 17%, the UDAM was able to maintain its healthcare activities and continued most of the treatments. The most modified treatment was CT, with the addition of prophylactic G-CSF, to avoid myelosuppression and potential complications from COVID-19 infection.
ABSTRACT
Background: In March 2020, a health emergency was decreed due to COVID-19 and this produced changes in the organization of health services. One of the objectives of the reorganization that took place was a reduction in face-to-face consultations (FTFC), and the promotion of telephone consultations (TC). Objective: Evaluate the effectiveness of TC and the level of satisfaction of patients attending the Mastology Unit using this method during the COVID health emergency. Methods: A prospective, cross-sectional study. A survey was used to assess the effectiveness of TC and the level of satisfaction with the method. Results: Forty-two patients were surveyed, of which 69% were receiving adjuvant treatment and 14.2% palliative treatment. With regard to the effectiveness of TC, 76.1% of those surveyed had their appointment resolved by telephone;78.6% of patients preferred to do the consultation by telephone;97.6% believed that sufficient time was spent and that the timing of the appointment was appropriate. The responses showed a high degree of satisfaction with the care received. The medical care met the expectations of all patients, and 83.3% believed that once normalcy was restored, TC would be an option for their situation. Conclusions: The TC method was evaluated with a high degree of satisfaction and allowed care to be maintained during the emergency. Although it is early to assess the healthcare impact of TC and the method's capacity to resolve issues, preliminary results show that it is a useful and valuable tool in clinical practice during periods of healthcare emergency. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.