Global changes to the chemotherapy service during the covid-19 pandemic.

PURPOSE: In response to the COVID-19 pandemic, changes to chemotherapy services were implemented as a means of managing imposed workload strains within health services and protecting patients from contracting COVID-19. Given the rapidly evolving nature of the pandemic many changes were rapidly adopted and were not substantiated by robust evidence. This study aimed to describe the changes adopted internationally to chemotherapy services, which may be used to guide future changes to treatment delivery. METHODS: A survey was developed to understand the impact of COVID-19 on the delivery of systemic anti-cancer therapies (SACT). It comprised 22 questions and examined the strategies implemented during the pandemic to prioritise and protect patients receiving SACT and the participants' professional opinion of the strategies employed. The survey was available in English, Spanish and French and was distributed via professional bodies. RESULTS: 129 responses were obtained from healthcare professionals working across 17 different countries. 45% of institutions had to implement treatment prioritisation strategies and all hospitals implemented changes in the delivery of treatment, including: reduction in treatments (69%), using less immunosuppressive agents (50%), allowing treatment breaks (14%) and switching to oral therapies (45%). Virtual clinic visits were perceived by participants as the most effective strategy to protect patients. CONCLUSIONS: The pandemic has forced chemotherapy healthcare professionals to adopt new ways of working by reducing health interactions. Many areas of research are needed following this period, including understanding patients' perceptions of risks to treatment, utilisation of oral treatments and the impact of treatment breaks on cancer outcomes

Código Cáncer: resultados preliminares

Antecedentes: Los retrasos en la atención de personas con cáncer impactan negativamente su calidad de vida y aumentan los costos al sistema de salud. / Objetivo: Describir las fases del proyecto Código Cáncer y sus resultados preliminares. / Métodos: Se organizaron siete grupos de investigación para: a) entender las causas de los retrasos que enfrentan las personas con cáncer en México, sus trayectorias y costos asociados; b) conocer los mecanismos de referencia formales e informales que constituyen su trayectoria en el sistema de salud, y c) entender la infraestructura existente y la necesaria para responder a las necesidades epidemiológicas del país. / Resultados: Estos resultados sientan las bases para la implementación de un programa de referencia rápida de pacientes. / Conclusión: Las políticas de diagnóstico y tratamiento oportuno del cáncer basadas en la evidencia son imprescindibles para atender los retrasos en la atención. Código Cáncer representa un proyecto innovador para lograr este objetivo en México

Code Cancer: preliminary results

Background: Delays in medical intervention for people living with cancer negatively impact the quality of life and increase costs to the healthcare system. // Objective: To describe the “Code Cancer” project phases and their preliminary results. Methods: Seven research groups organized to: a) understand the causes of delays faced by people with cancer in Mexico, their trajectories, and associated costs; b) understand the formal and informal referral mechanisms that constitute their trajectory in the health system, and c) understand the existing and necessary infrastructure to respond to the epidemiological needs of the country. // Results: These preliminary results lay the groundwork for implementing a rapid patient referral program.// Conclusions: Evidence-based policies for early cancer diagnosis and treatment are essential to address delays in medical assistance. “Code Cancer” represents an innovative project to achieve this goal in Mexico

Health-care policies during the COVID-19 pandemic in Mexico: A continuous case of heterogeneous, reactive, and unequal response

Background: The pandemic in Mexico underlined pre-existing health-care system inequalities. Within the first six months of the COVID-19 pandemic, 154 health policies across health institutions were found to be uncoordinated and heterogeneous, leading to health inequalities in access and potential health outcomes. Data & methods: Using a rapid qualitative research methodology, data was collected using purposive sampling of institutional policies published for public access on the official websites of the four public health institutions in Mexico from June 16th, 2020 to October 30th, 2021. This policy review used archival analysis to understand the differences in health-care policies during the COVID-19 pandemic in Mexico. These policies were classified under the RREAL framework and as a continuation of our first publication. Results: During this study, categories of public health response and vaccination dominated the policies enacted. The SSA was the main author of publications. There seems to be a more unified policy response. However, health inequalities persist. Conclusions: The Mexican government continued to be reactive to the increase in cases or the arrival of new variants, rather than preventative. Research and development of policies need to work together in soaring cases like COVID-19 to work more effectively against the economic and epidemiological burden of a pandemic. It is suggested that this “vaccination” should be included in the RREAL classification. Other sectors (i.e. the ministry of foreign affairs) should be considered relevant players in the future management of a pandemic