Perspectives from the Cancer and Aging Research Group: Caring for the vulnerable older patient with cancer and their caregivers during the COVID-19 crisis in the United States

Mohile, Supriya G.; DuMontier, Clark; Mian, Hira; Loh, Kah Poh; Williams, Grant R.; Wildes, Tanya M.; Boyd, Kevin; Ramsdale, Erika; Pyne, Sonia; Magnuson, Allison; Tew, William P.; Klepin, Heidi D.; Dale, William; Shahrokni, Armin

doi:10.1016/j.jgo.2020.04.010

Cited by 38 publications

(38 citation statements)

References 64 publications

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“…These findings demonstrate a need to ensure continued flow of care and to improve the infrastructure of patient access. Clinicians should consider simple interventions that are beneficial to all stakeholders (patients, providers, institutions), appropriately based on medical need, and avoid potential exposure to COVID-19 while continuing therapeutic relationships and cancer management [27]. Additional supports for accessing and receiving telemedicine as well as transportation and basic essentials for older adults with cancer need to be established, financially supported, and communicated to healthcare providers and patients.…”

Section: Discussionmentioning

confidence: 99%

Experiences of healthcare providers of older adults with cancer during the COVID-19 pandemic

Krok‐Schoen

Pisegna

BrintzenhofeSzoc

et al. 2021

Journal of Geriatric Oncology

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Objectives: Care for older adults with cancer became more challenging during the COVID-19 pandemic. We sought to examine healthcare providers' clinical barriers, patient questions, and overall experiences related to care delivery for these patients during the pandemic. Materials and methods: Members of the Advocacy Committee of the Cancer and Aging Research Group along with the Association of Community Cancer Centers developed a 20-question survey for healthcare providers of older adults with cancer. Eligible participants were recruited by email sent through professional organizations' listservs, email blasts, and social media. This manuscript reports the qualitative data from the survey's three open-ended questions. Free text, open-ended survey items were analyzed by two independent coders for identification of common themes using NVivo software. Theme agreement was reached through consensus and count comparisons of participant responses were made. Results: Healthcare system organizational challenges and meeting basic needs and support were commonly reported themes among respondents (n = 274). Barriers to care delivery included organizational challenges, patients' access to resources and support, concerns for patients' mental and physical health, and telehealth challenges. Respondents reported older adults were asking about their health and cancer care as well as access to basic needs and supports. Providers described worrying about patients' mental health, fear of personal safety, frustration in multi-level institutions, as well as experiencing positive leadership and communication. Conclusion: Providers are faced with balancing their concerns for personal and patient safety. These findings demand resources and support allocation for older adults with cancer and healthcare providers during the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

Experiences of healthcare providers of older adults with cancer during the COVID-19 pandemic

Krok‐Schoen

Pisegna

BrintzenhofeSzoc

et al. 2021

Journal of Geriatric Oncology

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“…As the frontline physician among us observed, the most challenging cancer care component during COVID-19 is how to resume cancer treatment for patients [ 1 ]. Because the pandemic has caused severe limitations to access to cancer care and availability of transportation, across the world, many patients, even in severe conditions, had to suspend their treatment plans [ 1 , 56 , 62 ]. Take Chinese cancer patients, for instance.…”

Section: Discussionmentioning

confidence: 99%

Technology-based health solutions for cancer caregivers to better shoulder the impact of COVID-19: a systematic review protocol

McDonnell

Liang

et al. 2021

Syst Rev

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Background Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning cancer caregivers' distinctive challenges amid COVID-19. Methods A systematic search of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus from the database inception to the end of March 2021. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy will be developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process. Conclusions COVID-19 has upended cancer care as we know it. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond. Systematic review registration PROSPERO CRD42020196301

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“…In these times, it is paramount to evaluate in the out-patient setting and stratify the risk of delirium in patients prior to administering any anticancer therapy. Hence, the impact of social isolation as a result of recommendations on physical distancing, risk of delirium, and decisions regarding anticancer treatment are important issues to assess and pro-actively address [ 25 ].…”

Section: Impact Of the Covid-19 Pandemic On Older Adults With Cancermentioning

confidence: 99%

“…COVID-19 vaccine) trials underway, inclusion of eligible older patients with cancer should be considered. As recently outlined by the CARG investigators [ 25 ], multicenter and international collaborations and novel methods of rapid dissemination will be crucial to elucidate the interaction between global health measures (rather than age alone) and oncological outcomes, along with endpoints particularly meaningful for older adults, such as function and quality of life.…”

Section: Researchmentioning

confidence: 99%

Adapting care for older cancer patients during the COVID-19 pandemic: Recommendations from the International Society of Geriatric Oncology (SIOG) COVID-19 Working Group

Battisti

Mislang

Cooper

et al. 2020

Journal of Geriatric Oncology

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The COVID-19 pandemic poses a barrier to equal and evidence-based management of cancer in older adults. The International Society of Geriatric Oncology (SIOG) formed a panel of experts to develop consensus recommendations on the implications of the pandemic on several aspects of cancer care in this age group including geriatric assessment (GA), surgery, radiotherapy, systemic treatment, palliative care and research. Age and cancer diagnosis are significant predictors of adverse outcomes of the COVID-19 infection. In this setting, GA is particularly valuable to drive decision-making. GA may aid estimating physiologic reserve and adaptive capability, assessing risk-benefits of either providing or temporarily withholding treatments, and determining patient preferences to help inform treatment decisions. In a resource-constrained setting, geriatric screening tools may be administered remotely to identify patients requiring comprehensive GA. Tele-health is also crucial to ensure adequate continuity of care and minimize the risk of infection exposure. In general, therapeutic decisions should favor the most effective and least invasive approach with the lowest risk of adverse outcomes. In selected cases, this might require deferring or omitting surgery, radiotherapy or systemic treatments especially where benefits are marginal and alternative safe therapeutic options are available. Ongoing research is necessary to expand knowledge of the management of cancer in older adults. However, the pandemic presents a significant barrier and efforts should be made to ensure equitable access to clinical trials and prospective data collection to elucidate the outcomes of COVID-19 in this population.

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Perspectives from the Cancer and Aging Research Group: Caring for the vulnerable older patient with cancer and their caregivers during the COVID-19 crisis in the United States

Cited by 38 publications

References 64 publications

Experiences of healthcare providers of older adults with cancer during the COVID-19 pandemic

Experiences of healthcare providers of older adults with cancer during the COVID-19 pandemic

Technology-based health solutions for cancer caregivers to better shoulder the impact of COVID-19: a systematic review protocol

Adapting care for older cancer patients during the COVID-19 pandemic: Recommendations from the International Society of Geriatric Oncology (SIOG) COVID-19 Working Group

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