Lessons learned from COVID-19: improving breast cancer services from the patient perspective

Globally, health services for breast cancer (BC) were significantly disrupted due to the coronavirus disease (COVID-19) pandemic (1)and the recovery and adaptation of health services is widely unknown(2). The purpose of this study is to reflect on the health service experiences of women with a diagnosis of BC in Ireland during the pandemic and to propose patient-centered priorities and recommendations to improve BC services moving forward from COVID-19. The study included semi-structured qualitative interviews (n = 28) with women who participated in a related mixed-methods cohort study. Women with a diagnosis of BC within 5 years in Ireland were initially enrolled and women were selected for interviews through stratified purposive sampling to ensure data was available on diverse cases. Interviews took place in early 2023 to reflect on perspectives from the COVID-19 government lockdown. Thematic analysis was conducted using NVivo software. Thematic analysis highlighted three main themes: unmet needs; patient priorities; and recommendations. Women discussed unmet needs such as routine care fall-out, mental well-being, and financial difficulties. Patient priorities included cohesion among multidisciplinary BC care, proper communication with BC health professionals, and self-empowerment in BC care. Lastly, women recommended improvements for the transition from active treatment, support services, and adaptation of telemedicine. “I do think that any patient going through cancer treatments, it's not just breast cancer, any patient ... there needs to be a little bit more support for the aftercare.” The pandemic has impacted BC services considerably, and this impact has accentuated unmet needs for women with BC in Ireland. Considering these unmet needs from varying backgrounds, patient- centred priorities and recommendations were proposed. To conclude, the patient voice should be prioritized when implementing changes for improvement to health services. KEY MESSAGES: • Health systems must learn from the pandemic to improve services and to avoid detrimental impact of future disasters. • The patient voice should be a key stakeholder when implementating health policies.