Challenges and perspective of cancer patients during the COVID-19 pandemic and the Lebanese financial crisis: a multicentric cross-sectional study

Abstract

Lebanese cancer patients are facing a war on two fronts, between the COVID-19 pandemic and one of the most severe financial crises globally in recent times. This multicentric cross-sectional study was conducted, aiming to analyse challenges and perspective of this particularly vulnerable population. A questionnaire was prepared to assess socio-demographic data, challenges faced during the pandemic, perspectives concerning cancer and COVID-19, a scale was also validated to assess knowledge level regarding COVID-19 in this population. Patients were interviewed in chemotherapy units from four different private and public hospitals in Lebanon during December 2020 and March-June 2021. In total, 272 patients were interviewed (median age, 57 years, range, 22-90 years). Concerning salary during the pandemic, it changed negatively (45.6%), or did not change (7.7%), while 46.7% of participants did not work. Some challenges such as transportation problems (39%), inability to reach their physician by phone (16.9%), deferral of chemotherapy dates (31.6%), difficulty finding chemotherapy medications (49.6%) were more likely to be reported by patients receiving chemotherapy in public compared to private hospitals (p < 0.01 for each). Other challenges include not being able to find non-cancer-related medications (71.3%), this challenge being increased when comparing December 2020 with March-June 2021 (p < 0.02). Using a multivariate analysis, the best predictor for increased knowledge about COVID-19 was higher levels of education (p < 0.001). In conclusion, this study shows that cancer patients in Lebanon are facing many challenges that complicate different aspects of health. Perspective and challenges of these patients must be taken into consideration in order to deliver better care to our patients in these unprecedented times.

The lived experiences of patients with cancer during the COVID-19 pandemic: a qualitative study

“…Similarly, to our findings, the authors reported that the majority of patients expressed a greater fear of cancer than COVID-19, and encountered transportation challenges to and from the hospital. However, while in our study participants agreed that precautionary measures in both private and public hospitals were very well implemented, Nawfal et al [7] reported that approximately a quarter of participants experienced difficulty in maintaining precautionary measures in both private and public hospitals. This difference might be related to differing practices and standards between medical centres.…”

“…Nawfal et al [ 7 ] conducted a survey study exploring the same question addressed in our research but focusing on other medical centres around Lebanon. Similarly, to our findings, the authors reported that the majority of patients expressed a greater fear of cancer than COVID-19, and encountered transportation challenges to and from the hospital.…”

The evolving Lebanese drug crisis: Trends in drug availability and affordability for common outpatient diseases from 2019 to 2023

“…We excluded these medications, in part, because treatment most commonly occurs in infusion centers. However, there have been PLOS GLOBAL PUBLIC HEALTH documented shortages in both oncology drugs and associated palliative and supportive drugs, which should be further explored [21]. Secondly, when calculating mean monthly income estimates for August 2021 and April 2023, we assumed a fixed dollar amount compared to January 2022 (see methods), despite ongoing devaluation of salaries in USD.…”

Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: a qualitative study

“…Financial toxicity associated with cancer care negatively impacts both cancer patients themselves and their families, who may be forced to make financial sacrifices to cope with cancer costs [3]. The COVID-19 pandemic has undeniably worsened the financial challenges faced by people living with cancer, particularly in the low-and middle-income countries (LMICs) [4,5].…”