ABSTRACT
Background: We conducted a survey among practicing pediatric oncologists in India to assess the modifications made in supportive-care during the pandemic, specifically if any of those were safe and effective enough to be practice-changing. Method(s): A survey-questionnaire with 27 questions was circulated through the emailing list and WhatsApp/Telegram groups of Indian pediatric oncology group in January 2022. Responses were accepted till 31st March 2022. The questions focused on disruptions in continuation of patient-care over past two years, strategies to minimize the impact of such disruptions, and the potential, if any, for incorporating these modifications into standard practice. Result(s): Of seventy-one responses from approximately 250 active members contacted, 39(55%) were from public hospitals and 23(32%) from centers seeing >200 new cases/year. Decline in new patient registration, funding shortage, increase in treatment abandonment and delay in maintenance/follow-up visits were reported by 7(9.8%), 37(52%),44 (62%), and 52(73%). In 25(35.2%) centers, scarcity of ICU beds during COVID waves resulted in higher non-COVID mortality/morbidity. Several centers reduced transfusion cut-offs (23,33%), used granulocyte stimulating factors more often (21, 30%), increased use of oral antibiotics in low-risk febrile neutropenia(FN) (29,40%), and stopped intravenous antibiotics earlier (11,15%). Strategies to curtail abandonment and drug default included tracking phone calls (50,72%), couriering medicines to patients homes (27,39%) and teleconsultation (43,62%). PostGAMMACotreatment follow-up frequency and investigations were reduced in 50(70%) centers and 54(76%) started teleconsultations;respondents considered these strategies likely to be incorporated into routine practice. While 35(49%) respondents supported increased use of outpatient chemotherapy, most(70,99%) respondents chose to revert to pre-pandemic policies for transfusion and FN. Establishment of sustainable shared-care networks was considered a priority by 44(62%). Conclusion(s): Pediatric oncology services were remarkably compromised during the pandemic. Of the many adaptations made to tackle the pandemic conditions, virtual follow-up of selected patients and rationalizing post-treatment follow-up and investigations are likely to continue into the post-pandemic period. Copyright © 2022