ABSTRACT
Objectives: Opioids play a significant role in the effective management of cancer-related pain. The COVID-19 lock down may have reduced access to opioids and caused a decline in the use of prescription of opioids among cancer survivors. This study compared opioid prescription rates among cancer survivors before and after the onset of COVID-19 pandemic using real-world electronic health records (EHR). Method(s): Cohort analyses of cancer patients using data from EHR database from the TriNetX, a global federated health research network across 76 healthcare organizations. We analyzed changes in prescription opioid use before (March 1, 2018, through March 1, 2019) and after onset of COVID-19 (April 01, 2020, through March 2021) among cancer survivors. The key outcome variable was any opioid prescription within 1 year of cancer diagnosis. One-to-one propensity score matching was used to balance the characteristics (age, sex, race, diagnoses including diabetes, hypertensive diseases, overweight, mood disorders, and visual disturbances) of the two cohorts. Data were analyzed using the TriNetX platform. Result(s): There were 1,502,143 cancer survivors before COVID-19 and 1,412,599 cancer survivors after the onset of COVID-19. The one-to-one propensity-score match yielded 1,382,561 cancer patients, mean age 64 at cancer diagnosis, and 73% were white. Percentage of opioid use among cancer patients declined from 35.6% before the COVID-19 to 35.1% after the onset of the pandemic (OR=0.976, 95% CI 0.971-0.981). Average number of opioid prescriptions within 1 year of cancer diagnosis declined from 5.7 before to 5.3 after the COVID-19 onset (p<0.001). Conclusion(s): Among cancer survivors, a small decline in prescription opioid use was observed after the onset of COVID-19 pandemic. Future studies are needed to distinguish the impact of revised guidelines, opioid prescription policy changes, and COVID-19 lock down on lower rates of prescription opioid use among cancer survivors.Copyright © 2023
ABSTRACT
Objectives: In the process of conducting research to understand barriers to colorectal cancer (CRC) screening in underrepresented groups such as Blacks and Hispanics, it became evident that there were also barriers to recruitment in this population. This study assesses the challenges faced in recruitment of focus group participants regarding CRC screening practices among underrepresented groups. Since the COVID-19 pandemic, qualitative research participants have primarily been interviewed through online video or audio interactions. However, as restrictions on in-person interactions have been lifted, in-person focus groups are being increasingly considered. Method(s): The study investigators began recruitment through community health workers in August 2022, when COVID-19 vaccines were available for all adults (age>18 years). Eligible individuals were: age 45-75, Black or Hispanic, with Medicaid or no insurance, and no family history of CRC or diagnosis of certain colon-related diseases. We combined in-person and virtual recruitment strategies, including posting flyers in communities, advertising our study at health fairs, and on social media. Participants would receive a $50 gift card. Result(s): Fifty-five met the eligibility criteria among 144 respondents, and 45 subjects (29 women and 16 men) agreed to be contacted. An average of 2.5 attempts were made per eligible subject. Unfortunately, we were able to recruit only four women (3 Hispanic and one non-Hispanic black). Traveling to the research site was a barrier to participation. Many subjects (49%) requested virtual participation (online video or audio interactions);some declined because the topic was too sensitive (considered taboo), and eligible men were reluctant to participate in-person. Conclusion(s): The requirement of in-person participation affected our recruitment goals, suggesting that COVID-19 has shifted the preferences of research participants to virtual interaction. In response to the eligible participant preferences, the study protocol has been revised to re-contact patients and schedule virtual FG sessions.Copyright © 2023
ABSTRACT
Objectives: Many patients with long COVID experience at least one vision problem. This study determines the association of long COVID with seeing difficulties. Method(s): We conducted a cross-sectional analysis with the Census Household Pulse Survey data (N = 51,288). We excluded adults who reported contracting COVID within the past four weeks, those with missing data on seeing difficulty when infected with COVID, and long COVID. Long COVID was defined as having symptoms lasting three months or longer that the adults did not have prior to having COVID. Adults self-reporting to a question on seeing with "some difficulty," "a lot of difficulty," or "unable to do" were classified as having "seeing difficulties." We conducted Chi-square tests and logistic regressions with replicate weights. Logistic regressions adjusted for long COVID, sex, age, race and ethnicity, marital status, income, education, food sufficiency, health insurance, remote work, vaccine doses, region, depression, and anxiety. Result(s): During the survey period (November 2 - November 14, 2022), 37.3% reported seeing difficulties, and 14.4% reported long COVID. A higher percentage of adults with long COVID reported seeing difficulties than those without long COVID (47.6% vs. 31.9%). In the fully adjusted logistic regression model, compared to adults with no COVID or without long COVID, those with long COVID had greater odds of seeing difficulties (AOR = 1.50, 95%CI = 1.32, 1.70). We did not observe a statistically significant difference between adults without long COVID and no COVID (AOR = 1.01, 95%CI = 0.93, 1.10 p = 0.7888). Conclusion(s): One in eight adults had long COVID. Adults with long COVID had significantly higher odds of seeing difficulties than those without long COVID. Therefore, a follow-up of patients with long COVID needs to include screening for seeing difficulties. More research is needed on the links between long Covid and vision care.Copyright © 2023