ABSTRACT
SARS-COV 2 recently caused a global pandemic, with the first case being reported in Romania in February 2020. Important restrictive measures were imposed, so that the addressability of patients to medical services decreased. Upper gastrointestinal bleeding had more severe forms of evolution at the time of presentation, which required additional methods of diagnosis and treatment. This is a retrospective study performed on 268 patients, which aims to evaluate the type and effectiveness of different treatment methods for upper gastrointestinal bleeding during the COVID 19 pandemic. Severity assessment was performed by measuring the Rockall score and additional methods of diagnosis. The association of COVID-19 with upper gastrointestinal bleeding can lead to much more severe outcomes for the patient, so treatment must be sustained and fast established. If the initial therapeutic methods fail, the other available therapeutic measures should be introduced progressively and without delay to achieve the best possible outcomes.
ABSTRACT
Introduction: Two years in, COVID-19 continues to impact healthcare systems and the treatment and care all patients receive, including those living with lung cancer. The Global Lung Cancer Coalition (GLCC) is a partnership of 42 patient organisations across 30 nations dedicated to improving outcomes for lung cancer patients. The GLCC used its third annual global patient experience survey to explore whether the pandemic had affected the extent to which patients are able to be involved in decision-making around their treatment and care. Methods: Among several topics in the survey, the GLCC’s multi-national steering group of patients, advocates, and clinicians included a question to ask about the extent to which patients felt involved in decisions about their treatment and care when talking to their treatment team. The survey received 555 responses from lung cancer patients across 21 countries. Results: Globally, almost half (48%, 258/533) of patients responding to the 2022 survey said they did not feel fully involved in decisions about their treatment and care, with almost one in ten (9%, 48/533) noting that they were not involved but would like to have been. This is a smaller proportion than in the 2021 survey, where 59% (755/1287) of responding patients stated that they did not feel fully involved in decision-making. The national data in Figure 1 highlights variation in the extent to which patients felt involved in decision-making. In both years, the country with the highest proportion of respondents feeling fully involved in decisions was the Netherlands (76% in 2022 and 75% in 2021). Conclusions: The GLCC’s patient charter highlights that every patient should have informed self-determination, which includes involvement in decision-making. This survey highlights the importance of treatment teams asking, and supporting, lung cancer patients to be as involved in decisions around their treatment and care as they wish to be. In all countries, there is scope to increase the extent to which patients feel involved in decision-making. Research is needed to identify best practice from countries where larger proportions of respondents felt fully involved in decision-making. Keywords: patient involvement, decision making, COVID-19 [Formula presented]
ABSTRACT
Introduction: Lung health checks or screening programmes are a key measure to detecting the disease earlier, when treatment is most likely to be successful, and thus reducing the huge burden currently imposed on the individuals affected, their families, the country, and the healthcare system as a whole. The Global Lung Cancer Coalition (GLCC), a partnership of 42 patient organisations across 30 nations, states in its patient charter that all patients have the right to witness the widespread implementation of well structured, evidence-based programmes of early diagnosis, including screening. With few countries currently offering screening programmes, the GLCC wanted to understand if patients would be willing to attend an appointment if it was available and they were invited. Methods: In the GLCC’s third annual survey, the steering group included questions on the availability of screening in their country, including a question asking patients if they would attend a lung health check or screening programme if invited. The survey received 555 responses from patients across 21 countries. Results: The majority of responding patients (85%, 449/526) said they would attend a screening appointment or lung health check if they were invited. The number of patients willing to attend ranged from 100% in Spain and Ireland to 63% in the USA. One in ten patients (54/526) said they were unsure if they would attend a screening appointment, and almost one in 20 (4%, 23/526) stated that they would not attend. Patients in Italy (17%, 22/129), Taiwan (17%, 12/71) and the USA (37%, 10/27) most frequently selected these options, although the proportions are lower than those stating that they would attend a screening appointment. Figure 1 shows a breakdown of responses by country. Conclusions: Lung health checks or screening programmes are available in very few countries worldwide, despite the increasing number of people being diagnosed every year. The findings from this survey demonstrate that the majority of patients would have been willing to attend a screening appointment to detect their lung cancer earlier if it had been available and they had been invited. As stated in the GLCC patient charter, in countries where lung cancer screening programmes are not available, governments should look to implement pilots as a matter of urgency, as evidence suggests that screening programmes support earlier detection and diagnosis and better patient outcomes. Keywords: advocacy, screening, COVID-19 [Formula presented]
ABSTRACT
Introduction: The Global Lung Cancer Coalition (GLCC) is a partnership of 42 patient organisations across 30 nations dedicated to improving outcomes for lung cancer patients. During the COVID-19 pandemic, many lung cancer patients were offered virtual (telephone or video) consultations alongside or instead of face-to-face appointments. Reasons included protecting patients from exposure to the virus, saving travel time, and freeing-up clinical time. As health systems explore the potential of hybrid systems of telemedicine post-COVID-19, the GLCC wanted to understand patients’ preferences for speaking to their treatment team and how they felt about virtual consultations. Methods: In its third annual online patient survey, the GLCC included questions to ask how patients would like to be able to contact their treatment team in different situations. In total, the survey received 555 responses from patients across 21 countries. Results: The findings show that globally, the majority of responding patients would prefer to see their treatment team in person when: finding out their diagnosis (91%, 406/444);having their first consultation (94%, 412/438);having regular check-ups (78%, 349/450);and there is a change to their treatment (84%, 374/444). However, if they are worried about something, many patients would also be willing to have a telephone consultation (32%, 146/452). Figure 1 highlights that patients in almost all countries favoured telephone over video consultations in all situations. However, video consultations were preferred over telephone consultations by patients in the USA for regular check-ups, and in Taiwan if there is a change to treatment. Conclusions: The findings highlight the importance of treatment teams seeking to understand patients’ preferred methods of contact. Support will be needed for treatment teams and for patients if health systems are to successfully transition to a hybrid model of virtual and in-person appointments. This includes treatment teams and patients having appropriate settings and IT in which to conduct virtual consultations. Patients should be asked whether virtual consultations are working for them, since preferences may change with their experience of technology. Keywords: advocacy, virtual consultations, COVID-19 [Formula presented]