Impact of the COVID-19 Pandemic on Palliative Care in Cancer Patients in Spain

Abstract

Background: The COVID-19 pandemic outbreak has severely affected healthcare organizations worldwide, and the provision of palliative care (PC) to cancer patients has been no exception. The aim of this paper was to analyse the levels of health care provided by the Clinical Management Unit for PC in Córdoba (Spain) for cancer patients. Method: a retrospective cohort study was conducted. It analyzed the PC internal management database including all cancer patients treated in the period of 2018–2021. Results: 1967 cases were studied. There was a drop in cancer cases (p = 0.008), deaths at the PC hospital (p < 0.001), and referrals from primary care (p < 0.001). However, there was a rise in highly complex clinical situations (p = 0.020) and in ECOG performance status scores of 3–4 (p < 0.001). The pandemic was not shown to be a risk factor for survival in the PC program (0.99 [0.82–1.20]; p = 0.931). However, being female (p = 0.005), being older and having a high Karnofsky Performance Status (KPS) score (p < 0.001) could be indicators of a longer stay. Conclusion: The COVID-19 pandemic has presented a challenge in the management of patients requiring PC and has highlighted the urgent needs of the healthcare system if it is to continue providing a level of care which meets the needs of patients and their families.

Impact of the coronavirus disease 2019 pandemic on delivery of and models for supportive and palliative care for oncology patients

“…Delivery of palliative and supportive care to hospital inpatients escalated during the pandemic; in the case of cancer patients, this trend may, at least in part, have reflected decreased utilization of hospice/PCU care [ 52 ]. Notably, an increase in admissions to a general hospital in-patient unit for the express purpose of symptom palliation was observed, as well as an increase in palliative care consult requests for inpatients on general medical wards [ 53 , 54 ]. In the latter context, 39% of patients were assessed in-person, and 61% by virtual means [ 51 ▪ ], though this ratio varied by institution and jurisdiction.…”

“…As noted, referrals made to the palliative care service from the inpatient wards in general hospitals increased during the pandemic (up to 42%, in one report from Spain); at the same time, there was a corresponding decrease in referrals from the outpatient/primary care setting [ 53 ]. Overall, these authors reported no change in the total number of cancer patients treated by palliative and supportive care services during the pandemic, compared with the prepandemic period.…”

Epidemiological features and changes in the occurrence of infectious diseases in Poland from 2015 to 2020 in the context of the emerging novel SARS-CoV-2 (COVID-19) pandemic

“…The comprehensive data concerning the impact of COVID-19 on cancer care in Europe reported that the pandemic had caused about a 20% decrease in the referral of newly diagnosed patients to oncological care [35]. This same observation was made about access to palliative care [36].…”

Palliative care for cancer patients during the COVID‐19 pandemic: A narrative synthesis from 36 studies of 16 countries

“…Several patients have reported decreased quality of life and depression because of the COVID‐19 epidemic (Beltran‐Aroca et al, 2021; Dhavale et al, 2020; Mishra et al, 2022; Nyblom et al, 2022; Yennurajalingam et al, 2022; Yildiz Kabak et al, 2021). This change may be related to fear of infection with COVID‐19 (Mishra et al, 2022), fear of disease progression (Yildiz Kabak et al, 2021), and fear of incomplete treatment (Dhavale et al, 2020).…”