Blood cancers

Large reduction in healthcare services accessed by blood cancer patients during pandemic

Blood cancer patients may need extra help when it comes to accessing healthcare services during the COVID-19 pandemic, particularly via telehealth, Australian researchers say.

A survey of 394 haematological cancer patients saw a significant decline in pre- versus peri-pandemic allied health-use despite face-to-face, telephone, video conferencing and email access opportunities during the 2020 study period. There was even a small drop in patient-reported haematologist consults.

Beyond government-mandated quarantine and isolation, the reduction in contact with treating physicians, support coordinators, psychologists and other services “may relate to patients’ privacy concerns, limited capacity to use telehealth tools, reduced allied health service needs over time and/or the progressive reorganisation of services during the early stages of the pandemic”, University of Melbourne psycho-oncology postdoctoral research fellow Nienke Zomerdijk and her team wrote in Leukaemia and Lymphoma.

The gap may have increased as patients were disillusioned with telehealth — with many saying virtual services made it harder to build relationships with their care team and resulted in less effective communication.

Nearly 80% of telehealth appointments occurred via telephone, and 63% and 52% of respondents agreed that telehealth would save them time and make it easier to attend appointments. However just 39% were “interested in receiving some or all of their future care via telehealth”, while 35% wanted to go back to face-to-face and the remainder were unsure.

Nevertheless, the study authors believed, telehealth would will likely continue to be key to maintaining care, particularly for immunocompromised haematology patients at higher risk for severe COVID-19-related complications from face-to-face consults.

“Uptake of video-conferencing platforms that enable effective communication should be encouraged,” they recommended, suggesting that the ability to see facial cues and body language could help patients build rapport with their carers in a way that telephone conversations couldn’t. These platforms will need to be secure so patients can be assured of their privacy and confidentiality, the authors added.

Regardless of consultation platform, however, “patients should be encouraged to follow-up on their health concerns and maintain contact with Allied Health professionals using appropriate social distancing measures and and/or telehealth”, they wrote.

This is important to maintain continuity of care and help allay anxieties around COVID-19 related changes to care, health risks and social isolation.

It will also be critical beyond the pandemic as telehealth becomes routine practice in haematological care, they concluded.

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