ABSTRACT
Background: The Sars-CoV-2 pandemic led to a reorganization of all hospitals activities and assistance to cancer patients has also undergone changes. Our Medical Oncology Unit-AOU Careggi, in the lockdown phase, has provided guidelines to assist patients who receive oral cancer treatment with 'telemedicine'. Aim of this work is to analyze the different ways in which the oncological visits scheduled for the prescription of oral therapy were performed. Material and methods: We consulted the agenda of oncology visits for oral therapies scheduled between 09 March and 26 March 2020: 115 patients were included in the study. We retrospectively compared the agenda with the medical records. Most of the patients (74%) scheduled in March followed a 28-day dosing schedule (q28), 13.04% q21, for the remainder the control was less frequently. Moreover, we also recorded subsequent visits, until May 2020. We divided the visits into 3 groups: the first group includes visits scheduled only in March, the second in April (> 90%) and the third in May (> 90%). Results At the first scheduled visit during the lockdown, 1 patient did not come, in 2 cases the caregiver came, 3 patients have postponed the visit, 10 were managed by phone, 53 by phone and e-mail, 46 came to visit. In the first and third phase, patients received the drug or prescription mainly directly in the clinic (40.17% and 47.94% respectively), in contrast, in the second phase, shipping by courier was preferred (37.5%). We noticed a correlation between the basal ECOG performance status (PS), assessed before the pandemic spread, and the modality of the visit (p< .001). Most patients (55.75%) with PS ECOG 0 carried out the first visit in the lockdown phase electronically (e-mail and telephone contact). However, no statistically significant correlation emerged between the Charlson comorbidity index and the method of carrying out the visit (p 0.998). Comparing the baseline PS and that recorded at the last visit, a statistically significant deterioration emerged (p < .001). Considering the baseline ECOG PS 0, at the third visit 52.94% of the evaluable patients maintained the PS. In 18 patients the data is missing. Conclusions: Telemedicine seems to be feasible in some contexts. The challenge is to select the right patient in the right moment. PS could be a screening tool but other factors should be investigated such as availability of appropriate technology for telemedicine.