Background

The COVID-19 pandemic has impacted many aspects of the practice of oncology around the world. COVID was first detected in Ireland on 29/2/20. Many oncology units saw dramatic changes in activity in the face of rising infection rates. We aim to assess compare pharmacy activity, day unit systemic therapy adminstration and nursing staffing levels during the pre- and COVID periods.

Methods

Hospital information systems were used to retrieve numbers of patients attending, numbers and types of items dispensed by pharmacy, and available nurses to deliver the systemic therapies from March 2019 to Feb. 2021. The data was analysed to identify trends in prescribing and dispensing practices for this period. Supportive medications such as anti-emetics, bisphosphosphonates were not included. Subgroup analysis on numbers of chemotherapy, immunotherapy, monoclonal antibody drugs dispensed per month was performed. A paired t-test was used to compare means.

Results

9410 non-clinical trials and 411 clinical trials items were dispensed from March 2019 until February 2020 (pre-COVID) for 11,606 patient attendances. From March 2020 until February 2021 (COVID period), 8931 non-clinical trials and 826 clinical trials items were dispensed for 10818 patient attendances. The mean number of non-clinical trials items dispensed per month were 784 and 744 respectively, with no statistical difference being found (p=0.11). There was a doubling in the number of clinical trials agents dispensed. The mean number of nurses available to administer therapies per day was 5.7 (SD=0.78) compared to the projected 7.8 WTE (whole time equivalents) ideally required. Table: CN43

Mean number of dispensed non-clinical trial agents per month per time period

Conclusions

Despite COVID restrictions it was possible to administer comparable numbers of cancer treatments throughout the COVID period, when compared to the previous year despite modest nursing staff numbers due to the dedication and selflessness of nursing, oncologists and oncology pharmacy staff.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Background

There is limited understanding of how the experiences of people with cancer may change and evolve against the shifting landscape of COVID-19 incidence, mortality, vaccination and healthcare delivery. This study aimed to explore the experiences of cancer care among people affected by cancer during the COVID-19 pandemic using a longitudinal qualitative study design.

Methods

Participants were recruited to this longitudinal descriptive qualitative study via social media advertisements. Sixteen semi-structured interviews were conducted with people living with, after or caring for someone with cancer at three timepoints over a six-month period during the COVID-19 pandemic. Interviews were recorded, transcribed and analysed thematically.

Results

Participants described feeling afraid and keeping safe through prevention and shielding strategies. Some had been vaccinated by phase 2 but many had not. Although hospitals felt safe and efficient, some participants felt COVID-19 restrictions were being used an excuse for compromised care. Substitution of face-to-face appointments with telehealth services restricted participants' access to professional and social support and reliable information. In phase one participants felt public health measures to reduce transmission of COVID-19 had created a sense of not missing out, but this feeling had largely shifted by phase 2 and the continued restrictions on social interactions amplified feelings of isolation.

Conclusions

This study highlights opportunities for longitudinal qualitative research to explore evolving experiences of people with cancer in the context of changing socio-cultural and healthcare provision during the COVID-19 pandemic.

Legal entity responsible for the study

The authors.

Funding

National University of Ireland, Galway, Ireland; Promotions Project Phase 2 Research Consolidation Grant.

Disclosure

All authors have declared no conflicts of interest.