Impact of Covid-19 Pandemic on Utilization of Chemotherapy Services by Patients Attending Kenyatta National Hospital, Oncology Clinic

Abstract

Background The emergence of the novel Coronavirus has challenged the robustness of healthcare systems worldwide. Strategies instituted by various Governments’ and healthcare institutions to combat the virus have been postulated to negatively impact on healthcare delivery. The complexity of managing COVID-19 has already affected management of diseases at risk especially the noncommunicable diseases like cancer. Additionally, empirical evidence regarding changes in healthcare utilization among patients during COVID-19 is limited. Objective The main objective of the study was to identify the changes in chemotherapy utilization before and during COVID-19, and also identify the possible determinants that influenced the utilization of chemotherapy during the COVID-19 pandemic Methodology The study was conducted at Kenyatta National Hospital-Cancer Treatment Centre (CTC). It was divided into two parts. The first part involved a descriptive cross-sectional study design. The study targeted adult patients on cancer chemotherapy attending the out-patient clinic. A simple randomization technique without replacement was used to obtain a representative sample of 241 participants. Data was collected using a researcher administered questionnaire and analysed using Stata version 13 software. Descriptive and inferential statistics were done. The level of significance was set at 0.05. Logistic regression was conducted to determine the variables that were independent predictors of chemotherapy utilization. The second part was a time series analysis of the chemotherapy attendance recorded from January 2019- December 2020 by the Health records department. The average quarterly scores were analyzed using an interrupted generalized linear regression analysis using R software. Results Among the 241 participants recruited, 36(14.9%) had missed at least one scheduled chemotherapy appointment while 205(85.1%) had not missed a single appointment since the inception of Covid-19. This indicated that the prevalence of missed chemotherapy appointment in this cohort was 14.9%. A phone call to the doctor during the tight Covid-19 restrictions and the marital status were positively associated with.............................................................................................