# What are the functional outcomes and service experiences of patients with head and neck cancer treated during the COVID-19 pandemic?

## TL;DR

This study examines how the pandemic affected head and neck cancer care, finding that treatment access and outcomes were similar, but patient experiences were negatively impacted.

## Contribution

The study provides new insights into patient experiences during pandemic-related changes in HNC care using mixed methods.

## Key findings

- Service modality shifted significantly to phone and telehealth during the pandemic.
- Patients during the pandemic felt less informed and reported less appropriate and acceptable care.
- Thematic analysis identified six key areas affecting patient experiences during the pandemic.

## Abstract

Head and neck cancer (HNC) care was significantly impacted by the COVID-19 pandemic. The current study aimed to explore the functional outcomes and service experiences of patients with HNC treated during and prior the COVID-19 pandemic.

Mixed methods were used to (1) retrospectively compare HNC patients’ functional outcomes and allied health service usage across two time-controlled cohorts and (2) understand the experiences of HNC care using validated surveys and qualitative interviews.

Retrospective data was extracted for 78 participants (pre-COVID-19, n = 43; during-COVID-19, n = 35), with n = 28 and n = 18 completing surveys and an interview, respectively. Significant differences were found in service modality between groups with significantly more phone and telehealth services provided during COVID-19. Service usage and functional outcomes were not significantly different between groups. During-COVID-19 participants reported being significantly less informed about their care and care was significantly less appropriate and acceptable. Thematic analysis of interviews revealed six broad themes related to communication, person-centred care, treatment logistics, care availability, safety of care, and impacts on experiences.

This study revealed that whilst HNC care rapidly changed at the onset of COVID-19, patient access to treatment and functional outcomes did not differ significantly. Rather, factors related to the patient experience of care were discussed. Healthcare professionals working in HNC have further evidence supporting building relationships based on transparent communication and partnering with patients to overcome rapid clinical changes, as experienced during COVID-19.

The online version contains supplementary material available at 10.1007/s00520-024-08811-w.