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Chazan G, Jupp J, Bauters T, Duncan N, Weddle KJ, Nomura H, O'Connor S, Chan A, Alkhudair N, Alshamrani M, Buie LW, Chambers P, Chieh TW, DeRemer DL, Duvivier F, Katabalo D, McFarlane T, Mckavanagh D, Mensah K, Martinez EM, Rowan G, Sae-Teaw M, Tadesse TA, Weru I, Alexander M. Impact of coronavirus of 2019 on the delivery of pharmacy services to patients with cancer: An international survey of oncology pharmacy practitioners. J Oncol Pharm Pract 2021; 28:1832-1847. [PMID: 34693814 DOI: 10.1177/10781552211048892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The coronavirus of 2019 pandemic has necessitated vast and rapid changes in the way oncology pharmacy services are delivered around the world. METHODS/AIMS An international survey of oncology pharmacists and technicians was conducted via the International Society of Oncology Pharmacy Practitioners and collaborating global pharmacy organisations to determine the impact that the coronavirus of 2019 has had on pharmacy service delivery, pharmacy practitioners and oncology practice. RESULTS The survey received 862 responses from 40 different countries from September to October 2020. The majority of respondents were pharmacists (n = 841, 97.6%), with 24% involved in the direct care of patients with the coronavirus of 2019. Of the survey participants, 55% increased their time working remotely, with remote activities including dispensing, patient assessment/follow-up and attending multi-disciplinary rounds. Respondents reported a 72% increase in the use of technology to perform remote patient interaction activities and that participation in educational meetings and quality improvement projects was reduced by 68% and 44%, respectively. Workforce impacts included altered working hours (50%), cancelled leave (48%) and forced leave/furloughing (30%). During the pandemic, respondents reported reduced access to intensive care (19%) and anti-cancer (15%) medications. In addition, 39% of respondents reported reduced access to personal protective equipment, including N95 masks for chemotherapy compounding. Almost half of respondents (49%) reported that cancer treatments were delayed or intervals were altered for patients being treated with curative intent. A third of practitioners (30%) believed that patient outcomes would be adversely impacted by changes to pharmacy services. Sixty-five percent of respondents reported impacts on their mental health, with 12% utilising support services. CONCLUSION The coronavirus of 2019 pandemic has altered the way oncology pharmacy services are delivered. These results demonstrate the adaptability of the oncology pharmacy profession and highlight the importance of formal evaluation of the varied practice models to determine the evidence-based practices that enhance pharmacy services and, thus, should be reinstated as soon as practical and reasonable.
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Affiliation(s)
- Grace Chazan
- Sir Peter MacCallum Department of Oncology, 60078University of Melbourne, Australia.,Department of Medical Oncology, 3085Peter MacCallum Cancer Centre, Australia
| | - Jennifer Jupp
- Pharmacy Services, 3146Alberta Health Services, Canada
| | - Tiene Bauters
- Pharmacy Department, 60200Ghent University Hospital, Belgium
| | - Nick Duncan
- Pharmacy Department, 156807Queen Elizabeth Hospital, UK
| | | | - Hisanaga Nomura
- Department of Data Science/Pharmacy, 444492National Cancer Center Hospital East, Japan
| | - Shaun O'Connor
- Pharmacy Department, St Vincent's Hospital, Australia.,Commissioning and System Improvement Division, 1457Department of Health Victoria, Australia
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, 8788University of California, USA
| | - Nora Alkhudair
- Department of Clinical Pharmacy, College of Pharmacy, 37850King Saud University, Saudi Arabia
| | - Majed Alshamrani
- Pharmaceutical Care Services, 47798Ministry of National Guard Health Affairs, Saudi Arabia
| | - Larry W Buie
- Pharmacy Department, 5803Memorial Sloan Kettering Cancer Center, USA
| | - Pinkie Chambers
- 4919University College London Hospital NHS Trust & University College London School of Pharmacy, UK
| | - Tan Wen Chieh
- Pharmacy Department, 69844University Malaya Medical Centre, Malaysia
| | - David L DeRemer
- Department of Pharmacotherapy and Translational Research, 15505University of Florida College of Pharmacy, USA
| | | | - Deogratias Katabalo
- 227206Bugando Medical Center, Tanzania.,150778Catholic University of Health and Allied Sciences, School of pharmacy, Department of Pharmacy Practice and Therapeutics, Tanzania
| | | | - Daniel Mckavanagh
- Office of the Chief Clinical Information Officer, Clinical Excellence Queensland, 1288Queensland Health, Australia
| | - Kofi Mensah
- Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, 98763Kwame Nkrumah University of Science and Technology, Ghana.,Discipline of Pharmaceutical Sciences, College of Health Sciences, 56394University of KwaZulu-Natal, South Africa.,Pharmacy Practice Department, Faculty of Pharmacy and Pharmaceutical Sciences, 98763Kwame Nkrumah University of Science and Technology, Ghana
| | | | - Gail Rowan
- Pharmacy Department, 3085Peter MacCallum Cancer Centre, Australia
| | - Manit Sae-Teaw
- Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Thailand
| | - Tamrat Assefa Tadesse
- School of Pharmacy, College of Health Sciences, 37602Addis Ababa University, Ethiopia
| | - Irene Weru
- Pharmacy Division, 285569Kenyatta National Hospital, Kenya
| | - Marliese Alexander
- Sir Peter MacCallum Department of Oncology, 60078University of Melbourne, Australia.,Pharmacy Department, 3085Peter MacCallum Cancer Centre, Australia
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Chan RJ, Emery J, Cuff K, Teleni L, Simonsen C, Turner J, Janda M, Mckavanagh D, Jones L, McKinnell E, Gosper M, Ryan J, Joseph R, Crowe B, Harvey J, Ryan M, Carrington C, Nund R, Crichton M, McPhail S. Implementing a nurse-enabled, integrated, shared-care model involving specialists and general practitioners in breast cancer post-treatment follow-up: a study protocol for a phase II randomised controlled trial (the EMINENT trial). Trials 2020; 21:855. [PMID: 33059741 PMCID: PMC7558254 DOI: 10.1186/s13063-020-04740-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background Due to advances in early detection and cancer treatment, 5-year relative survival rates for early breast cancer surpass 90% in developed nations. There is increasing focus on promotion of wellness in survivorship and active approaches to reducing morbidity related to treatment; however, current models of follow-up care are heavily reliant on hospital-based specialist-led care. This study aims to test the feasibility of the EMINENT intervention for implementing an integrated, shared-care model involving both cancer centre specialists and community-based general practitioners for early breast cancer post-treatment follow-up. Methods We describe a protocol for a phase II, randomised controlled trial with two parallel arms and 1:1 allocation. A total of 60 patients with early-stage breast cancer will be randomised to usual, specialist-led, follow-up care (as determined by the treating surgeons, medical oncologists, and radiation oncologists) or shared follow-up care intervention (i.e. EMINENT). EMINENT is a nurse-enabled, pre-specified shared-care pathway with follow-up responsibilities divided between cancer centre specialists (i.e. surgeons and oncologists) and general practitioners. The primary outcome is health-related quality of life as measured by the Functional Assessment of Cancer Therapy—Breast Cancer. Secondary outcomes include patient experience, acceptance, and satisfaction of care; dietary, physical activity, and sedentary behaviours; financial toxicity; adherence; health resource utilisation; and adverse events. Discussion The trial is designed to identify the barriers to implementing a shared-care model for breast cancer survivors following treatment. Results of this study will inform a definitive trial testing the effects of shared-care model on health-related quality of life of breast cancer survivors, as well as its ability to alleviate the growing demands on the healthcare system. Trial registration Australia and New Zealand Clinical Trials Registry ACTRN12619001594112. Registered on 19 November 2019
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Affiliation(s)
- Raymond Javan Chan
- Division of Cancer Services, Proncess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia. .,School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Jon Emery
- Department of General Practice and Centre for Cancer Research, University of Melbourne, Melbourne, Victoria, Australia
| | - Katharine Cuff
- Division of Cancer Services, Proncess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia
| | - Laisa Teleni
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Camilla Simonsen
- Division of Cancer Services, Proncess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia
| | - Jane Turner
- Faculty of Medicine, University of Queensland & Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Monika Janda
- Centre for Health Services Research, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Daniel Mckavanagh
- Division of Cancer Services, Proncess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia
| | - Lee Jones
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Emma McKinnell
- Division of Cancer Services, Proncess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia
| | - Melissa Gosper
- McGrath Foundation & Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia
| | - Juanita Ryan
- Division of Surgery, Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia
| | - Ria Joseph
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Bethany Crowe
- Division of Cancer Services, Proncess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia
| | - Jennifer Harvey
- Radiation Oncology Centre, Princess Alexandra Hospital, Metro South Health and University of Queensland, Brisbane, Queensland, Australia
| | - Marissa Ryan
- Pharmacy Department, Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia
| | - Christine Carrington
- Pharmacy Department, Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia
| | - Rebecca Nund
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Megan Crichton
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Steven McPhail
- Australian Centre For Health Services Innovation (AusHSI), Queensland University of Technology, Brisbane, Queensland, Australia.,Clinical Informatics Division, Metro South Health, Brisbane, Queensland, Australia
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