Nov. 25, 2021
The coronavirus disease 2019 (COVID-19) pandemic has changed treatment options for patients with brain and spinal tumors, slowed research efforts, and increased the risk of burnout among practitioners. Those are among the key findings of a global study published in the February 2021 issue of Neuro-Oncology Advances — the first international study of COVID-19's impact on the field of neuro-oncology.
"Given the unique circumstances we have encountered, this study could serve as a benchmark for assessing the status of neuro-oncology," says Maciej M. Mrugala, M.D., Ph.D., a neuro-oncologist at Mayo Clinic in Phoenix/Scottsdale, Arizona, and the study's first author. "We have learned a lot that we would otherwise not have known, without the crisis situation and the study."
The study — an effort by the Society for Neuro-Oncology — involved a survey of practitioners, scientists and trainees from 21 neuro-oncology organizations across six continents. The survey was conducted from April 24 to May 17, 2020. Among the 582 respondents, 45% were based in the United States and 55% were abroad.
Specific findings from practitioners include:
- 94% changed their clinical practices, with almost all transitioning to video or telephone visits for some aspects of clinical care.
- 85.9% canceled what were deemed nonessential patient appointments.
- 61.4% suspended phase 3 trial enrollments.
- 27.4% altered standard of care regimens, including delays in chemotherapy and radiotherapy.
- 19.5% reported that already scheduled surgeries proceeded at times or very often in the absence of adequate personal protective equipment.
- 60% of elective surgical procedures were rescheduled, and 37% were canceled.
Although most practitioners reported increased stress, only 56% had psychosocial support offered by their institutions. A large percentage of respondents faced significant financial losses.
The study also found some positive aspects of the pandemic. Nearly 75% of respondents agreed or strongly agreed that patients and families had increased satisfaction due to a lower burden of time and money spent traveling to appointments. Technologies applied to patient care and virtual meetings among colleagues were also cited as positive aspects.
"What we learned during the pandemic — both the positives, such as a successful use of telemedicine in neuro-oncologic practice, and the negatives, such as the impact on clinical and basic research and lack of psychological support for staff — can serve as great lessons for improving care in neuro-oncology and preventing similar issues in the future," Dr. Mrugala says.
The researchers recommend that institutions:
- Modify clinical trial infrastructure to avoid trial closures
- Remove pressure on providers to see patients in person when not clinically necessary, and provide support for billing education for telephone and video visits
- Provide psychological support for staff and consider additional support for practitioners with children and elder care responsibilities
"A follow-up study would be very helpful to see if institutions were able to implement some of the changes we suggested and to see how the situation evolved with different stages of the pandemic," Dr. Mrugala says.
For more information
Mrugala MM, et al. The state of neuro-oncology during the COVID-19 pandemic: A worldwide assessment. Neuro-Oncology Advances. 2021;3:vdab035.