TY - JOUR
T1 - Medical care disruptions during the first six months of the COVID-19 pandemic
T2 - the experience of older breast cancer survivors
AU - Thinking and Living with Cancer Study
AU - Dilawari, A.
AU - Rentscher, K. E.
AU - Zhai, W.
AU - Zhou, X.
AU - Ahles, T. A.
AU - Ahn, J.
AU - Bethea, T. N.
AU - Carroll, J. E.
AU - Cohen, H. J.
AU - Graham, D. A.
AU - Jim, H. S.L.
AU - McDonald, B.
AU - Nakamura, Z. M.
AU - Patel, S. K.
AU - Root, J. C.
AU - Small, B. J.
AU - Saykin, A. J.
AU - Tometich, D.
AU - Van Dyk, K.
AU - Mandelblatt, J. S.
AU - Akiba, Chie
AU - Arsenyan, Anait
AU - Bailey, Jessica
AU - Butler, Grace
AU - Carpenter, Savannah
AU - Carr, Caitlin
AU - Chamberlain, Megan
AU - Charles, Kemeberly
AU - Chen, Amy
AU - Choi, Jennifer
AU - Cook, Elana
AU - Fallon, Julia
AU - Farberov, Maria
AU - Fatovic, Robin
AU - Filo, Julie
AU - Hoekstra, Alyssa
AU - Hussin, Mallory
AU - Katheria, Vani
AU - Kennedy, Brittany
AU - Lee, Ty
AU - Levi, Abe
AU - McClendon, Trina
AU - McNeal, Kat
AU - Mihalache, Meghan
AU - Obremski, Kelsey
AU - O’Brian, Olivia
AU - Ornduff, Renee
AU - Roberts, Elsa
AU - Rose, Melissa
AU - Song, Minna
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2021/11
Y1 - 2021/11
N2 - Purpose: Older cancer survivors required medical care during the COVID-19 pandemic, but there are limited data on medical care in this age group. Methods: We evaluated care disruptions in a longitudinal cohort of non-metastatic breast cancer survivors aged 60–98 from five US regions (n = 321). Survivors completed a web-based or telephone survey from May 27, 2020 to September 11, 2020. Care disruptions included interruptions in seeing or speaking to doctors, receiving medical treatment or supportive therapies, or filling prescriptions since the pandemic began. Logistic regression models evaluated associations between care disruptions and education, medical, psychosocial, and COVID-19-related factors. Multivariate models included age, county COVID-19 death rates, comorbidity, and post-diagnosis time. Results: There was a high response rate (n = 262, 81.6%). Survivors were 32.2 months post-diagnosis (SD 17.5, range 4–73). Nearly half (48%) reported a medical disruption. The unadjusted odds of care disruptions were higher with each year of education (OR 1.22, 95% CI 1.08–1.37, p = < 0.001) and increased depression by CES-D score (OR 1.04, CI 1.003–1.08, p = 0.033) while increased tangible support decreased the odds of disruptions (OR 0.99, 95% CI 0.97–0.99, p = 0.012). There was a trend between disruptions and comorbidities (unadjusted OR 1.13 per comorbidity, 95% CI 0.99–1.29, p = 0.07). Adjusting for covariates, higher education years (OR1.23, 95% CI 1.09–1.39, p = 0.001) and tangible social support (OR 0.98 95% CI 0.97–1.00, p = 0.006) remained significantly associated with having care disruptions. Conclusion: Older breast cancer survivors reported high rates of medical care disruptions during the COVID-19 pandemic and psychosocial factors were associated with care disruptions. Clinicaltrials.gov Identifier: NCT03451383.
AB - Purpose: Older cancer survivors required medical care during the COVID-19 pandemic, but there are limited data on medical care in this age group. Methods: We evaluated care disruptions in a longitudinal cohort of non-metastatic breast cancer survivors aged 60–98 from five US regions (n = 321). Survivors completed a web-based or telephone survey from May 27, 2020 to September 11, 2020. Care disruptions included interruptions in seeing or speaking to doctors, receiving medical treatment or supportive therapies, or filling prescriptions since the pandemic began. Logistic regression models evaluated associations between care disruptions and education, medical, psychosocial, and COVID-19-related factors. Multivariate models included age, county COVID-19 death rates, comorbidity, and post-diagnosis time. Results: There was a high response rate (n = 262, 81.6%). Survivors were 32.2 months post-diagnosis (SD 17.5, range 4–73). Nearly half (48%) reported a medical disruption. The unadjusted odds of care disruptions were higher with each year of education (OR 1.22, 95% CI 1.08–1.37, p = < 0.001) and increased depression by CES-D score (OR 1.04, CI 1.003–1.08, p = 0.033) while increased tangible support decreased the odds of disruptions (OR 0.99, 95% CI 0.97–0.99, p = 0.012). There was a trend between disruptions and comorbidities (unadjusted OR 1.13 per comorbidity, 95% CI 0.99–1.29, p = 0.07). Adjusting for covariates, higher education years (OR1.23, 95% CI 1.09–1.39, p = 0.001) and tangible social support (OR 0.98 95% CI 0.97–1.00, p = 0.006) remained significantly associated with having care disruptions. Conclusion: Older breast cancer survivors reported high rates of medical care disruptions during the COVID-19 pandemic and psychosocial factors were associated with care disruptions. Clinicaltrials.gov Identifier: NCT03451383.
KW - Breast cancer
KW - COVID
KW - Cancer survivors
KW - Medical care disruptions
KW - Older adults
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U2 - 10.1007/s10549-021-06362-w
DO - 10.1007/s10549-021-06362-w
M3 - Article
C2 - 34515905
AN - SCOPUS:85115252528
SN - 0167-6806
VL - 190
SP - 287
EP - 293
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 2
ER -