The impact of the COVID-19 pandemic on palliative care practice: A survey of clinical oncologists

Abstract

BackgroundPalliative care is an essential intervention to improve the quality of life for patients with cancer, whereas the ongoing COVID-19 pandemic poses a challenge to supportive and palliative care providers. This survey aims to explore the current status of palliative care practice for cancer and the influence of COVID-19, from the perspective of oncologists.MethodsThe semi-structure electronic questionnaire was designed. Mixed-mode surveys including electronic questionnaires, face-to-face interactions, and telephone interviews were adopted according to the willingness of respondents. Face-to-face and telephone interviews were based on same questions in the online questionnaire. Participants working in cancer-related departments with frontline palliative care experience during the COVID-19 outbreak were included. Surveys covered experiences and perspectives regarding the impact of COVID-19 on clinical work, personal lives, and palliative care practice. Suggestions on coping strategies were further proposed and qualitatively analyzed.ResultsThirty-seven oncologists participated in this study from September 2021 to January 2022. The majority of them believed COVID-19 significantly and negatively affected their clinical work routines (75.7%), personal daily lives (67.6%), and palliative care practice (64.9%). Most specialists considered that currently the palliative care system remained underdeveloped (73.0%), and other factors besides COVID-19 were associated with this situation (78.4%). Seventeen participants further made suggestions on how to promote palliative care during COVID-19, and three themes emerged through the qualitative analysis: (1) Remote or online service (88.2%); (2) Publicity, education, or shared decision-making for patients (29.4%); (3) Guidelines, training, or programs for care providers (23.6%).ConclusionOncologists consider that COVID-19 has an adverse impact on their palliative care practice and daily routine. In addition to COVID-19, other factors affecting palliative care should not be neglected. Corresponding measures are warranted to encourage palliative care practice during COVID-19.

Induction PD-1 inhibitor toripalimab plus chemotherapy followed by concurrent chemoradiotherapy and consolidation toripalimab for bulky locally advanced non-small-cell lung cancer: protocol for a randomized phase II trial (InTRist study)

“…Thyroid function tests, urinalysis, coagulation parameters, etc., are also regularly measured during treatment at the times in the assessment schedules and as clinically indicated. Due to the impact of the COVID-19 pandemic ( 26 ), the periodic review during the consolidation therapy phase allows for a slight delay, but not exceeds one week. Serious AEs (SAEs) occurring during treatment or until the last dose of consolidation toripalimab, should be recorded and reported immediately and not exceeding 24h after the knowledge of SAEs.…”

Immune modulatory roles of radioimmunotherapy: biological principles and clinical prospects

“…Nevertheless, other studies suggested different RT doses and segmentations played various immunomodulatory role ( 87 ). Some scholars considered low-dose RT, which is commonly used for patients with metastatic diseases as palliative care ( 91 , 92 ), can better induce anti-tumor immune activation at the molecular level, reshape TIME, and improve the infiltration and function of effector immune cells in distant tumor foci ( 9 , 93 – 95 ). Therefore, anti-tumor responses outside the radiation field strengthened by low-dose RT were termed the “RadScopal effect” by them ( 9 , 96 ).…”