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Medical Care Disruptions During the First Six-Months of the COVID19 Pandemic: The Experience of Older Breast Cancer Survivors.
Dilawari, A; Rentscher, K E; Zhai, W; Zhou, X; Ahles, T A; Ahn, J; Bethea, T N; Carroll, J E; Cohen, H J; Graham, D A; Jim, Hsl; McDonald, B; Nakamura, Z M; Patel, S K; Root, J C; Small, B J; Saykin, A J; Tometich, D; Van Dyk, K; Mandelblatt, J S.
  • Dilawari A; Medstar Washington Hospital Center Washington, DC.
  • Rentscher KE; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.
  • Zhai W; Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA.
  • Zhou X; Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA.
  • Ahles TA; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.
  • Ahn J; Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC.
  • Bethea TN; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.
  • Carroll JE; Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC.
  • Cohen HJ; Memorial Sloan Kettering Cancer Center, New York, NY.
  • Graham DA; Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA.
  • Jim H; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.
  • McDonald B; Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA.
  • Nakamura ZM; Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC.
  • Patel SK; Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC.
  • Root JC; John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ.
  • Small BJ; Moffitt Cancer Center, Tampa, FL.
  • Saykin AJ; Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN.
  • Tometich D; Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, NC.
  • Van Dyk K; City of Hope National Medical Center, Los Angeles, CA.
  • Mandelblatt JS; Memorial Sloan Kettering Cancer Center, New York, NY.
Res Sq ; 2021 Apr 14.
Article in English | MEDLINE | ID: covidwho-1200427
Preprint
This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
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Semantic information from SemMedBD (by NLM)
1. At risk of infection PROCESS_OF Age Cohort
Subject
At risk of infection
Predicate
PROCESS_OF
Object
Age Cohort
2. Non-Metastatic Breast Carcinoma PROCESS_OF Survivors
Subject
Non-Metastatic Breast Carcinoma
Predicate
PROCESS_OF
Object
Survivors
3. At risk of infection PROCESS_OF Age Cohort
Subject
At risk of infection
Predicate
PROCESS_OF
Object
Age Cohort
4. Non-Metastatic Breast Carcinoma PROCESS_OF Survivors
Subject
Non-Metastatic Breast Carcinoma
Predicate
PROCESS_OF
Object
Survivors
ABSTRACT
PurposeOlder cancer survivors required medical care during the COVID-19 pandemic despite infection risks, but there are limited data on medical care in this age group.

METHODS:

We evaluated care disruptions in a longitudinal cohort of non-metastatic breast cancer survivors ages 60-98 from five US regions (n=321). Survivors completed a web-based or telephone survey from May 27, 2020 to September 11, 2020. Care disruptions included self-reported interruptions in ability to see doctors, receive treatment or supportive therapies, or fill prescriptions. Logistic regression models evaluated bivariate and multivariate associations between care disruptions and education, medical, psychosocial and COVID-19-related factors. Multivariate models included age, county COVID-19 rates, comorbidity and post-diagnosis time.

RESULTS:

There was a high response rate (n=262, 81.6%). Survivors were 32.2 months post-diagnosis (SD 17.5, range 4-73). Nearly half (48%) reported a medical disruption. The unadjusted odds of care disruptions were significantly higher with more education (OR 1.23 per one-year increase, 95% CI 1.09-1.39, p =0.001) and greater depression (OR 1.04 per one-point increase in CES-D score, CI 1.003-1.08, p=0.033); tangible support decreased the odds of disruptions (OR 0.99, 95% CI 0.97-0.99 per one-point increase, p=0.012). There was a trend for associations between disruptions and comorbidity (unadjusted OR 1.13 per 1 added comorbidity, 95% CI 0.99-1.29, p=0.07). Adjusting for covariates, only higher education (p=0.001) and tangible social support (p=0.006) remained significantly associated with having care disruptions.

CONCLUSIONS:

Older breast cancer survivors reported high rates of medical care disruptions during the COVID-19 pandemic and psychosocial factors were associated with care disruptions.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Year: 2021 Document Type: Article