Health-related quality of life of patients with haematologic cancer during COVID-19 and their opinions on telehealth consultations – a Danish single site cross-sectional survey  

Figures & data

Table 1. Patient characteristics.

	n (%)
Gender (n = 2236)
Male	1268 (57)
Female	966 (43)
I do not identify myself with a specific gender	2 (<1)
Age (n = 2226)
18–29	49 (2)
30–39	62 (3)
40–49	108 (5)
50–59	283 (13)
60–69	594 (27)
70–79	831 (37)
80–89	277 (12)
90+	22 (1)
Marital status (n = 2237)
Married/cohabiting	1612 (72)
Involved, not cohabiting	71 (3)
Divorced	94 (4)
Widow/widower	224 (10)
Single	234 (10)
Other	2 (<1)
Number of persons in the household (n = 2235)
1	564 (25)
2	1405 (63)
3	132 (6)
4	98 (4)
>4	36 (2)
Education (n = 2236)
Elementary school	447 (21)
Vocational basic course	325 (15)
General upper secondary education	53 (2)
Business upper secondary education	36 (2)
Short higher education (<3 years)	303 (14)
Medium higher education (3–4 years)	599 (27)
Long higher education (>4 years)	269 (12)
Other	113 (5)
I don’t want to answer/I don’t know	61 (2)
Haematological diagnosis (n = 2239) -->^a
Essential thrombocythemia	85 (4)
Leukaemia	435 (19)
Lymphoma	582 (26)
Multiple myeloma	291 (13)
Myelodysplasia	59 (3)
Myelofibrosis	39 (2)
Polycythemia vera	112 (5)
Other	438 (20)
I don’t want to answer/I don’t know	273 (12)
Haematological disease status (n = 2212)
Curable	625 (28)
Chronic?	1214 (55)
I don’t want to answer/I don’t know	373 (17)
Comorbid conditions (n = 2239)^a
Hypertension	797 (36)
Cardiovascular disease	272 (12)
Diabetes	202 (9)
Chronic obstructive pulmonary disease/Asthma	249 (11)
Kidney disease	85 (4)
Liver disease	32 (1)
None of the above	1008 (45)
I do not wish to answer/don’t know	105 (5)

Values are numbers (n) and percentages (%). ^aPossible to check more than one box, resulting in totals of more than 100%.

Table 2. Patients’ opinions on the use of telehealth as a means to conduct future clinician consultations.

	n (%)
Access to electronic devices (n = 2239)^a
Smartphone/cellphone	2054 (92)
Desktop or laptop computer	1707 (76)
Tablet/Ipad	1237 (55)
Internet access at your home	1752 (78)
Landline phone	606 (2)
I don’t want to answer/I don’t know	18 (1)
Could you imagine turning up for an appointment at the department of haematology if it was replaced by a telephone consultation? (n = 2227)
Yes	403 (18)
Yes, but not every time	1082 (49)
No	691 (31)
I do not wish to answer/I don’t know	51 (2)
Could you imagine turning up for an appointment at the department of haematology if it was replaced by a video consultation? (n = 2224)
Yes	316 (14)
Yes, but not every time	663 (30)
No	1174 (53)
I do not wish to answer/I don’t know	71 (3)
Is it important for you that contact with the department go through your primary care clinician? (n = 2218)
Yes	1150 (52)
No	692 (31)
Yes, but not necessarily every time	290 (13)
Do not wish to answer/I don’t know	86 (4)
Treatment group (n = 811)
If you could choose a time for treatment, which would suit you best?^a
8–12	579 (71)
12–16	270 (33)
16–20	67 (8)
I do not wish to answer/I don’t know	40 (5)
Could you imagine answering an electronic questionnaire about your symptoms and side effects prior to your scheduled treatment? (medical treatment, n = 763)
Yes	392 (51)
No	256 (34)
I do not wish to answer/I don’t know	115 (15)
Could you imagine answering an electronic questionnaire about your symptoms and side effects prior to your scheduled treatment? (radiotherapy treatment, n = 44)
Yes	28 (64)
No	11 (25)
I do not wish to answer /I don’t know	5 (11)
Could you imagine answering an electronic questionnaire about your symptoms and side effects prior to your scheduled treatment? (blood transfusion treatment, n = 117)
Yes	63 (54)
No	34 (29)
I do not wish to answer / I don’t know	20 (17)
Control follow-up group (n = 1416)
If you could choose a time for control follow-up, which would suit you best?^a
8–12	965 (68)
12–16	483 (34)
16–20	155 (11)
I do not wish to answer/I don’t know	66 (5)
Could you imagine answering an electronic questionnaire prior to your scheduled control follow-up? (n = 1400)
Yes	823 (59)
No	430 (31)
I do not wish to answer /I don’t know	147 (11)

Values are numbers (n) and percentages (%). ^aPossible to check more than one box resulting in totals of more than 100%

Table 3. Multivariable regression analysis of the emotional functioning, social functioning and Global Quality of Life domains of the EORTC QLQ-C30 questionnaire.

	Global QoL, n = 2211			EF, n = 2208			SF, n = 2211
	Coefficient	95%CI	p-Value	Coefficient	95%CI	p-Value	Coefficient	95%CI	p-Value
Haematological diagnose
Lymphoma	0			0			0
Essential thrombocythemia	0.24	−5.18; 5.66	0.93	0.05	−4.39; 4.49	0.98	−1.39	−7.02; 4.24	0.63
Leukaemia	−0.63	−3.49; 2.24	0.67	2.16	−0.19; 4.51	0.07	0.42	−2.56; 3.40	0.78
Multiple myeloma	−5.50	−8.69; −2.30	0.001	−0.84	3.45; 1.78	0.53	−4.05	−7.36; −0.74	0.02
Myelodysplasia	−1.98	−8.58; 4.61	0.56	−4.05	−9.40; 1.30	0.14	−0.29	−7.08; 6.50	0.93
Myelofibrosis	−1.30	−9.23; 6.63	0.75	−0.40	−6.89; 6.10	0.91	−3.33	−11.57; 4.91	0.43
Polycythemia vera	−1.93	−6.53; 2.67	0.41	0.48	−3.29; 4.25	0.80	0.67	−4.11; 5.45	0.78
Multiple of the diagnoses listed	−7.30	−12.19; −2.41	0.003	−2.29	−6.27; 1.70	0.26	−3.36	−8.42; 1.69	0.19
None of the above diseases/others	−1.60	−4.40; 1.20	0.27	−0.42	−2.72; 1.88	0.72	−0.01	−2.92; 2.91	0.10
I don’t want to answer/I don’t know	−3.50	−6.76; −0.24	0.04	−2.35	−5.02; 0.33	0.09	1.75	−1.64; 5.15	0.31
Have you refrained from consulting a doctor or the hospital due to fear of contracting COVID-19? (n = 2232)
No	0			0			0
Yes	−4.29	−7.54; −1.03	0.01	−4.68	−7.36; −2.01	0.001	−3.69	−7.08; −0.30	0.03
I do not wish to answer / I don’t know	−9.28	−19.05; 0.49	0.06	−5.77	−13.77; 2.23	0.16	−12.28	−22.43; −2.13	0.02
Are you concerned about contracting COVID-19? (n = 2235)
Not concerned	0			0			0
A little concerned	−3.86	−6.47; −1.25	0.004	−3.81	−5.95; −1.67	<0.001	−1.14	−3.86; 1.57	0.409
Moderately concerned	−7.45	−10.17; −4.73	<0.001	−6.75	−8.98; −4.52	<0.001	−3.80	−6.63; −0.97	0.008
Very concerned	−13.45	−16.60; −10.30	<0.001	−15.12	−17.71; −12.54	<0.001	−12.92	−16.20; −9.64	<0.001
Extremely concerned	−22.76	−28.73; 16.80	<0.001	−26.41	−31.29; −21.52	<0.001	−22.49	−28.68; −16.29	<0.001
I do not wish to answer/I don’t know	−13.35	−27.21; 0.52	0.06	−12.04	−23.40; −0.69	0.04	−19.03	−33.44; −4.62	0.010
_cons	77.64			91.73			90.02
R^2	0.07			0.11			0.07

EORTC QLQ-C30: the European Organisation for Research and Treatment of Cancer quality of life; QoL: quality of life; EF: Emotional functioning; SF: Social functioning.

Table 4. Sociodemographic and disease-related parameters for patients who were for vs. against the use of telehealth as a means to conduct future hospital consultations.

	Could you imagine turning up for a clinician appointment at the department if it was replaced by a:
	Telephone consultation			Video consultation
	Yes	No	p-Value	Yes	No	p-Value
Gender
Male	857 (69)	388 (31)		588 (48)	648 (52)
Female	626 (67)	302 (33)	0.50	391 (43)	523 (57)	0.03
Age
18–29	39 (80)	10 (20)		27 (59)	19 (41)
30–39	46 (78)	13 (22)		42 (71)	17 (29)
40–49	76 (72)	29 (28)		67 (64)	38 (36)
50–59	217 (78)	62 (22)		187 (68)	90 (32)
60–69	400 (69)	180 (31)		302 (53)	273 (47)
70–79	522 (64)	291 (36)		290 (36)	510 (64)
80–89	166 (63)	96 (37)		61 (23)	200 (77)
90+	14 (74)	5 (26)		3 (15)	17 (85)
Marital status
Married/cohabiting	1083 (68)	501 (32)		769 (49)	798 (51)
Involved/divorced/widow/widower/single	402 (68)	190 (32)	0.84	210 (36)	376 (64)	<0.001
Household
I live alone	357 (67)	177 (33)		173 (33)	359 (67)
I do not live alone	1128 (69)	512 (31)	0.41	806 (50)	813 (50)	<0.001
Education
Elementary school	272 (61)	177 (39)		122 (27)	324 (73 s)
Higher level of education (secondary education, short, medium and long higher education)	1117 (72)	444 (28)	<0.001	808 (52)	734 (48)	<0.001
Haematological diagnosis
Essential thrombocythemia	59 (83)	12 (17)		34 (49)	36 (51)
Leukaemia	289 (76)	89 (24)		192 (51)	183 (49)
Lymphoma	316 (59)	223 (41)		207 (39)	324 (61)
Multiple myeloma	174 (65)	93 (35)		129 (48)	140 (52)
Myelodysplasia	35 (76)	11 (24)		22 (50)	22 (50)
Myelofibrosis	24 (77)	7 (23)		16 (52)	15 (48)
Polycythemia vera	74 (73)	28 (27)		49 (49)	52 (51)
Multiple of the listed diagnoses	62 (70)	27 (30)		39 (46)	46 (54)
None of the above diseases/others	292 (72)	111 (28)		203 (51)	196 (49)
I don’t want to answer/I don’t know	154 (64)	88 (36)		87 (36)	154 (64)
Comorbid conditions
0	731 (68)	343 (32)		530 (50)	534 (50)
≥1	754 (68)	348 (32)	0.86	449 (41)	640 (59)	<0.001
Disease status^a
Curable	416 (68)	197 (32)		288 (47)	319 (53)
Incurable	841 (70)	354 (30)	0.27	557 (47)	632 (53)	0.81

Values are numbers (n) and percentages (%). ^aThe answer option ‘I don’t know/I don’t want to answer’ was left out of the analysis.

Table 5. Sociodemographic and disease related parameters for patients who reported none vs. mild to severe symptoms of anxiety and for patients who were not concerned vs. concerned about contracting COVID-19.

	Symptoms of anxiety (GAD-7)			Concerns of contracting COVID-19
	None	Mild to severe	p-Value	Not concerned	Concerned	p-Value
Gender
Male	1040 (83)	217 (17)		277 (22)	985(78)
Female	705 (75)	239 (25)	0.001	152 (16)	807 (84)	<0.001
Age
18–29	37 (76)	12 (24)		12 (24)	37 (76)
30–39	40 (65)	22 (35)		14 (23)	47 (77)
40–49	70 (65)	38 (35)		17 (16)	91 (84)
50–59	202 (72)	80 (28)		56 (20)	224 (80)
60–69	471 (79)	122 (21)		103 (17)	489 (83)
70–79	686 (83)	136 (17)		151 (18)	677 (82)
80–89	215 (83)	45 (17)		67 (24)	209 (76)
90+	20 (91)	2 (9)		9 (45)	11 (55)
Marital status
Married/cohabiting	1284 (80)	319 (20)		285 (18)	1321 (82)
Involved/divorced/widow/widower/single	462 (77)	138 (23)	0.11	145 (23)	473 (77)	0.002
Household
I live alone	422 (78)	117 (22)		136 (24)	422 (76)
I do not live alone	1322 (80)	340 (20)	0.53	294 (18)	1370 (82)	0.001
Education
Elementary school	357 (78)	101 (22)		100 (21)	374 (79)
Higher level of education (secondary education, short-cycle, medium-cycle, and long-cycle higher education)	1260 (80)	317 (20)	0.36	292 (18)	1287 (82)	0.21
Haematological diagnosis
Essential thrombocythemia	55 (80)	14 (20)		17 (24)	54 (76)
Leukaemia	34 (74)	12 (26)		75 (20)	307 (80)
Lymphoma	218 (81)	51 (19)		98 (18)	451(82)
Multiple myeloma	312 (82)	68 (18)		42 (16)	228 (84)
Myelodysplasia	426 (78)	122 (22)		4 (9)	43 (91)
Myelofibrosis	25 (81)	6 (19)		4 (13)	27 (87)
Polycythemia vera	83 (80)	21 (20)		20 (19)	84 (81)
Multiple of the listed diagnoses	69 (77)	21 (23)		13 (14)	79 (86)
None of the above diseases/others	319 (78)	90 (22)		89 (22)	323 (78)
I don’t want to answer/I don’t know	200 (80)	51 (20)		66 (26)	190 (84)
Comorbid conditions
0	871 (79)	226 (21)		231 (21)	866 (79)
≥1	877 (79)	231 (21)	0.89	199 (18)	928 (82)	0.04
Disease status^a
Curable	500 (80)	122 (20)		124 (20)	500 (80)
Incurable	943 (79)	257 (21)	0.37	220 (18)	989 (82)	0.38
Radiotherapy within last 2 months
Yes	30 (68)	14 (32)		7 (16)	38 (84)
No	1715 (80)	442 (20)	0.07	421 (19)	1751 (81)	0.52
Medical treatment within last 2 months
Yes	583 (77)	174 (23)		123 (16)	642 (84)
No	1161 (81)	280 (19)	0.05	305 (21)	1146 (79)	0.005
Blood transfusion within last 2 months
Yes	78 (68)	36 (32)		19 (16)	98 (84)
No	1667 (80)	418 (20)	0.003	409 (19)	1690 (81)	0.39

GAD-7: General Anxiety Disorder 7-item questionnaire. Values are numbers (n) and percentages (%). ^aThe answer option ‘don’t know/I don’t want to answer’ was left out of the analysis.