Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
Guillermo Valencia , Daniel Enriquez , Patricia Rioja , Lizbeth Lachira , Monica Calderon , Jeannie Navarro-Vasquez , Silvia P. Neciosup , Tatiana Vidaurre
Background: Advocacy programs in oncology has shown to improve outcomes through education, patient empowerment and civil society awareness, enabling better actions and efforts for patient care, especially in COVID-19 era. We present the results of a virtual survey conducted with the support of a Peruvian advocacy program for cancer patients in COVID-19 pandemic. Methods: In October 2020, a Peruvian Advocacy Program at Instituto Nacional de Enfermedades Neoplasicas (INEN) (“Club de la Mama”) formed by advocates and supported by a team of health professionals developed a virtual survey between October 2020 and July 2021 with the purpose of evaluating the impact of interruption of diagnosis or oncological treatment, detect a degree of anxiety/depression due to quarantine and provide information on the response of the oncological institution to the pandemic; from the patient’s perspective. This virtual survey includes: alternative treatment options, degree of anxiety/depression, early access to medical prescription, mode of appointment and quality of care. Patients answered the survey anonymously via web promoted on social networks (Facebook/ WhatsApp) and person-to-person diffusion. Results: A total of 244 patients were included, 78.7% females. Most of patients (86.5%) were from Lima and 86.9% had public insurance. 16.8% of patients had COVID-19 in the period of time evaluated. According to education level, 50.8% were superior, 37.7% high school, 10.7% elementary school and 0.8% illiterate. The most common cancer type was breast (36.1%), followed by hematologic (27.9%) and cervical (7.0%). The most common modality of care was in-person (73%), followed by telemedicine (15%) and only 2% not received medical consult. Regarding the degree of depression: 39% were mild, 14% moderate, 12% moderate-severe, 5% severe and 30% none. The most common degree of anxiety was 42% mild, 16% moderate, 12% severe, and 30% no degree. The most frequent reasons for not attending to hospital were unavailability of appointments (31%), followed by fear to COVID-19 (26%), geographic (10%) and difficulty in transportation (9.0%). The appointment cancellation/postponement time [reported in days] was: 18.0% not canceled, 16% [ < 15], 14% [15-30], 19% [30-60], 10% [60-90], 23% [ > 90]. Of the patients with surgical indication, 72% did not undergo surgery. Regarding prescription, 83% of patients received oncologic treatment, 10% did not received, and the remaining 7% answered that they did not need medication. Quality of care: 18% were considered excellent, 67% good, 10% fair, and 5% poor. Conclusions: Although the survey showed higher degrees of anxiety/depression in patients and longer cancellation/postponement/medication changes during COVID-19 pandemic, there was a significant adherence of medicine prescription, with no negative impact on the perception of quality of oncology care.
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