Abstract PO-027: Multi-institutional survey of COVID-19 impact in cancer care in patients and health care providers
Authors: Alarcon Sylvia V. , Salehi Omid , Vega Eduardo A. , Kazakova Vera , Conrad Claudius 
Published: December 2020

Abstract
Background: The COVID-19 pandemic has altered the priorities and capacities of health care systems worldwide, including how oncologic care is managed. Unprecedented changes to cancer care are being implemented to reduce rates of infection and conserve health care resources, while providing optimal cancer care. To this date, no comprehensive study has been conducted to assess the attitudes of both oncology patients and providers surrounding these changes.
Methods: A multi-institutional survey was provided to patients and oncology health care professionals. Demographics and clinical data were collected. Questions concerning treatment, safety, communication, and emotional stress before and after the pandemic outbreak was measured on a 5-point Likert scale. Open-ended responses were collected, scored in a blinded fashion by three providers, and evaluated using Nominal Group Technique. Wilcoxon signed-rank test and Wilcoxon rank-sum test were used to compare provider and patient answers where appropriate.
Results: Patient concerns regarding susceptibility to infection [z=2.536, p=0.011] and their cancer outcome [z=4.572, p&lt;0.001] were significantly increased during the COVID-19 period. Factors associated with increased concern were colorectal cancer, white race, stage 3 and 4, active treatment, and &lt;1 year since diagnosis. However, providers were more concerned regarding outcome than patients, believing that cancer care is overall more poorly planned [z=-3.857, p=&lt;0.001]. While patients were comparatively more worried about contracting COVID-19 than providers, providers felt less safe in clinic. Nonetheless, providers had more concern about patients contracting infection than patients themselves, felt facilities were less sanitary, and had less confidence in the hospital overall. Among providers, strong concerns regarding availability of protective personal equipment [z=-4.082, p&lt;0.001] and infecting providers’ families [z=4.965, p&lt;0.001] were identified. Further, providers (significantly more than patients) felt that cancer care planning and communication were worse than before COVID-19.
Conclusion: To our knowledge, this is the first multi-institutional survey to assess the impact of the COVID-19 pandemic on patients and providers. Patients had more difficulty coping during the pandemic, suggesting an increased need for emotional support. Nonetheless, patients did not perceive significant differences in their cancer treatment. This is in stark contrast to providers, who had major concerns regarding their ability to provide optimal cancer care, felt unprepared to handle the outbreak independent of the practice setting, and had personal safety concerns. This study suggests that more emotional support infrastructure for patients is required. Further, the bleak assessment of providers regarding effectiveness of their treatment and concerns for their personal safety raises concern for an increased risk of provider burnout, suggesting the need for novel targeted interventions.
Citation Format: Sylvia V. Alarcon, Omid Salehi, Eduardo A. Vega, Vera Kazakova, Claudius Conrad. Multi-institutional survey of COVID-19 impact in cancer care in patients and health care providers [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-027.