Dr. Brian Koffman, MDCM (retired), MSEd, a co-founder and Chief Medical Officer of the CLL Society, Inc., was recently featured on the Video Journal of Hematological Oncology. He discussed his findings of the impact of the coronavirus pandemic on the care of CLL patients. In addition, Dr. Koffman discussed this critical topic during the International Workshop on CLL (iwCLL) meeting held virtually in late September 2021.
“The current COVID-19 pandemic has challenged doctors’ ability to care for patients in the way we were most comfortable,” Koffman stated. In addition, it forced the healthcare team to look to new methods of care delivery, most notably telemedicine.
There have certainly been some advantages for CLL patients of the increased use of telemedicine. Compared to clinic visits, the reduced risk of exposure is a prime example of a benefit of telemedicine appointments and has impacted many CLL patients. A smaller group of patients benefited from receiving care from a CLL specialist outside their geographic area, where perhaps there are no specialists close. It will be interesting to see if Medicare and other insurers continue to afford favorable reimbursement to providers who use telemedicine as a tool to care for patients.
Dr. Koffman opined that CLL patient care was potentially negatively impacted by difficulties in the ability of the CLL patients and their doctors to build personal bonds that we know are a vital element of successful treatment outcomes. Another potential negative impact of telemedicine has been limited if any physical examination of the patient’s lymph nodes, spleen, and liver helps track the progress of both the disease and the effectiveness of treatment.
A significant concern for many physicians is that because patients are avoiding exposure risk, they have been postponing non-direct CLL care such as screenings for secondary cancers, a risk factor associated with CLL. In addition, patients with comorbidities have seen a reduction in appointments to monitor blood pressure, blood glucose, and other cardiovascular risks.
Dr. Koffman also stated that during this time, some patients had made different choices among treatment options to avoid trips to infusion centers in favor of oral treatment options.
The introduction of the COVID-19 vaccines has also impacted patient care choices. For example, some patients and physicians delay treatments until after the patient is fully vaccinated or choose to avoid therapies that delay the vaccine’s ability, such as monoclonal antibodies.
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Thomas E. Henry III, MBA, RPh, CPh
Thomas E. Henry III is a Registered Pharmacist and CLL Patient. He is President and Senior Consultant for Burlington Consulting Associates, a company that provides consulting services to health systems nationwide. Tom is a CLL Society Medical Advisory Board member and strives to educate other CLL patients through his blog https//www.cllpharmacist.com. He has a forty-two-year career as a licensed pharmacist and has served as Chief Pharmacy Officer at two Top-15 Comprehensive Cancer Centers, Moffitt (Tampa, FL) and Roswell Park Cancer Institute (Buffalo, NY)