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Medical care disruptions during the first six months of the COVID-19 pandemic: the experience of older breast cancer survivors

PURPOSE: Older cancer survivors required medical care during the COVID-19 pandemic, but there are limited data on medical care in this age group. METHODS: We evaluated care disruptions in a longitudinal cohort of non-metastatic breast cancer survivors aged 60–98 from five US regions (n = 321). Survi...

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Autores principales: Dilawari, A., Rentscher, K. E., Zhai, W., Zhou, X., Ahles, T. A., Ahn, J., Bethea, T. N., Carroll, J. E., Cohen, H. J., Graham, D. A., Jim, H. S. L., McDonald, B., Nakamura, Z. M., Patel, S. K., Root, J. C., Small, B. J., Saykin, A. J., Tometich, D., Van Dyk, K., Mandelblatt, J. S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8436022/
https://www.ncbi.nlm.nih.gov/pubmed/34515905
http://dx.doi.org/10.1007/s10549-021-06362-w
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author Dilawari, A.
Rentscher, K. E.
Zhai, W.
Zhou, X.
Ahles, T. A.
Ahn, J.
Bethea, T. N.
Carroll, J. E.
Cohen, H. J.
Graham, D. A.
Jim, H. S. L.
McDonald, B.
Nakamura, Z. M.
Patel, S. K.
Root, J. C.
Small, B. J.
Saykin, A. J.
Tometich, D.
Van Dyk, K.
Mandelblatt, J. S.
author_facet Dilawari, A.
Rentscher, K. E.
Zhai, W.
Zhou, X.
Ahles, T. A.
Ahn, J.
Bethea, T. N.
Carroll, J. E.
Cohen, H. J.
Graham, D. A.
Jim, H. S. L.
McDonald, B.
Nakamura, Z. M.
Patel, S. K.
Root, J. C.
Small, B. J.
Saykin, A. J.
Tometich, D.
Van Dyk, K.
Mandelblatt, J. S.
author_sort Dilawari, A.
collection PubMed
description PURPOSE: Older cancer survivors required medical care during the COVID-19 pandemic, but there are limited data on medical care in this age group. METHODS: We evaluated care disruptions in a longitudinal cohort of non-metastatic breast cancer survivors aged 60–98 from five US regions (n = 321). Survivors completed a web-based or telephone survey from May 27, 2020 to September 11, 2020. Care disruptions included interruptions in seeing or speaking to doctors, receiving medical treatment or supportive therapies, or filling prescriptions since the pandemic began. Logistic regression models evaluated associations between care disruptions and education, medical, psychosocial, and COVID-19-related factors. Multivariate models included age, county COVID-19 death rates, comorbidity, and post-diagnosis time. RESULTS: There was a high response rate (n = 262, 81.6%). Survivors were 32.2 months post-diagnosis (SD 17.5, range 4–73). Nearly half (48%) reported a medical disruption. The unadjusted odds of care disruptions were higher with each year of education (OR 1.22, 95% CI 1.08–1.37, p =  < 0.001) and increased depression by CES-D score (OR 1.04, CI 1.003–1.08, p = 0.033) while increased tangible support decreased the odds of disruptions (OR 0.99, 95% CI 0.97–0.99, p = 0.012). There was a trend between disruptions and comorbidities (unadjusted OR 1.13 per comorbidity, 95% CI 0.99–1.29, p = 0.07). Adjusting for covariates, higher education years (OR1.23, 95% CI 1.09–1.39, p = 0.001) and tangible social support (OR 0.98 95% CI 0.97–1.00, p = 0.006) remained significantly associated with having care disruptions. CONCLUSION: Older breast cancer survivors reported high rates of medical care disruptions during the COVID-19 pandemic and psychosocial factors were associated with care disruptions. CLINICALTRIALS.GOV IDENTIFIER: NCT03451383
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spelling pubmed-84360222021-09-13 Medical care disruptions during the first six months of the COVID-19 pandemic: the experience of older breast cancer survivors Dilawari, A. Rentscher, K. E. Zhai, W. Zhou, X. Ahles, T. A. Ahn, J. Bethea, T. N. Carroll, J. E. Cohen, H. J. Graham, D. A. Jim, H. S. L. McDonald, B. Nakamura, Z. M. Patel, S. K. Root, J. C. Small, B. J. Saykin, A. J. Tometich, D. Van Dyk, K. Mandelblatt, J. S. Breast Cancer Res Treat Clinical Trial PURPOSE: Older cancer survivors required medical care during the COVID-19 pandemic, but there are limited data on medical care in this age group. METHODS: We evaluated care disruptions in a longitudinal cohort of non-metastatic breast cancer survivors aged 60–98 from five US regions (n = 321). Survivors completed a web-based or telephone survey from May 27, 2020 to September 11, 2020. Care disruptions included interruptions in seeing or speaking to doctors, receiving medical treatment or supportive therapies, or filling prescriptions since the pandemic began. Logistic regression models evaluated associations between care disruptions and education, medical, psychosocial, and COVID-19-related factors. Multivariate models included age, county COVID-19 death rates, comorbidity, and post-diagnosis time. RESULTS: There was a high response rate (n = 262, 81.6%). Survivors were 32.2 months post-diagnosis (SD 17.5, range 4–73). Nearly half (48%) reported a medical disruption. The unadjusted odds of care disruptions were higher with each year of education (OR 1.22, 95% CI 1.08–1.37, p =  < 0.001) and increased depression by CES-D score (OR 1.04, CI 1.003–1.08, p = 0.033) while increased tangible support decreased the odds of disruptions (OR 0.99, 95% CI 0.97–0.99, p = 0.012). There was a trend between disruptions and comorbidities (unadjusted OR 1.13 per comorbidity, 95% CI 0.99–1.29, p = 0.07). Adjusting for covariates, higher education years (OR1.23, 95% CI 1.09–1.39, p = 0.001) and tangible social support (OR 0.98 95% CI 0.97–1.00, p = 0.006) remained significantly associated with having care disruptions. CONCLUSION: Older breast cancer survivors reported high rates of medical care disruptions during the COVID-19 pandemic and psychosocial factors were associated with care disruptions. CLINICALTRIALS.GOV IDENTIFIER: NCT03451383 Springer US 2021-09-13 2021 /pmc/articles/PMC8436022/ /pubmed/34515905 http://dx.doi.org/10.1007/s10549-021-06362-w Text en © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Clinical Trial
Dilawari, A.
Rentscher, K. E.
Zhai, W.
Zhou, X.
Ahles, T. A.
Ahn, J.
Bethea, T. N.
Carroll, J. E.
Cohen, H. J.
Graham, D. A.
Jim, H. S. L.
McDonald, B.
Nakamura, Z. M.
Patel, S. K.
Root, J. C.
Small, B. J.
Saykin, A. J.
Tometich, D.
Van Dyk, K.
Mandelblatt, J. S.
Medical care disruptions during the first six months of the COVID-19 pandemic: the experience of older breast cancer survivors
title Medical care disruptions during the first six months of the COVID-19 pandemic: the experience of older breast cancer survivors
title_full Medical care disruptions during the first six months of the COVID-19 pandemic: the experience of older breast cancer survivors
title_fullStr Medical care disruptions during the first six months of the COVID-19 pandemic: the experience of older breast cancer survivors
title_full_unstemmed Medical care disruptions during the first six months of the COVID-19 pandemic: the experience of older breast cancer survivors
title_short Medical care disruptions during the first six months of the COVID-19 pandemic: the experience of older breast cancer survivors
title_sort medical care disruptions during the first six months of the covid-19 pandemic: the experience of older breast cancer survivors
topic Clinical Trial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8436022/
https://www.ncbi.nlm.nih.gov/pubmed/34515905
http://dx.doi.org/10.1007/s10549-021-06362-w
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