Family Life During and Beyond COVID-19: The Impact of Relationship Quality on Caregivers' Management of Paid Work, Caregiving, and Self-Care

This multi-method project examined how Australian caregivers navigated family life during the COVID-19 pandemic in 2020 and subsequent impact on family health behaviours. Participants were invited to complete all three phases. In phase 1, 115 caregivers completed an online survey, focussed on 2020 experiences of COVID-19. In phase 2, 96 of the participants completed a use-of-time recall and 80 completed a dietary recall examining participants' health behaviours including how they spent their time, their physical activity, and diet quality. Phase 3 involved 24 of the participants completing an online story completion task, focussed on understanding participants' sense-making of COVID-19. Through triangulating analyses of the three phases, this project identified how poor relationship quality negatively affected families' experiences of significant disruptions and transitions. This project provides a nuanced picture of how COVID-19 in 2020 impacted family life and highlights the importance of caregiver relationship quality for family health and wellbeing.

Not well enough to attend appointments: Telehealth versus health marginalisation

Temporary telehealth initiatives during COVID-19 have been life-changing for many people in Australia;for the first time Frail, Homebound, and Bedridden Persons (FHBP) equitably received primary healthcare services, like Australians without a disability. However, government changes to telehealth funding mean that since July 2020 telehealth is only available for those who have attended a face-To-face appointment in the last 12 months, thus excluding FHBP. This paper illustrates the reported health exclusion and marginalisation of FHBP. We reviewed the literature and surveyed 164 Australian adults (27% homebound people and 73% affiliated persons) to ascertain their opinions and thoughts on potential strategies to tackle issues associated with FHBP's current circumstances. Results demonstrate that digital technologies and telehealth services are ethical imperatives. Policymakers, clinicians, and health researchers must work with end-users (community-based participation) to create an inclusive healthcare service. © 2021 The authors and IOS Press.

Off-label drugs: Use analysis and pharmacoepidemiology in a COVID centre in Rome

Background and importance The coronavirus pandemic has involved the sudden management of innovative therapeutic opportunities to counter it. A drug's off-label use has required a sudden supply and the production of legislation to settle such handling to target real data towards a shareable and objective data collection flow. Aim and objectives The aim of the study was to analyse the supply process of off-label drugs and reference to the national legislation for each medicinal product, regarding consumption data and the number of COVID-19 patients treated in a COVID centre in Rome, with 200 COVID beds and 40 beds in two intensive care units. Material and methods For the following products, the supply and handling data were analysed from 1 February 2020 to 31 July 2020: chloroquine, hydroxychloroquine, lopinavir/ ritonavir, darunavir/colbicistat, raltegravir and tocilizumab. The AIFA's reference regulations of these drugs were highlighted in the same period. Pharmacoepidemiological data were obtained. Results The drug's off-label request was first considered. After the AIFA's decision to include in the 648/96 Law (GU 69 17.03.2020) chloroquine, hydroxychloroquine, lopinavir/ ritonavir, darunavir/colbicistat, the UOC Pharmacy drafted a specific request form according to the 648/96 Law, to convey the supply and distribution of drugs to the departments through a reporting channel as the regulations required. 10 658 tablets of lopinavir/ritonavir were given to 250 patients, 660 tablets of darunavir/colbicistat to 32 patients, 302 150 tablets of hydroxychloroquine to 350 patients and 330 tablets of chloroquine to 33 patients. Raltegravir tablets were obtained for compassionate use for one patient. Tocilizumab was introduced through an off-label company procedure. Later, the centre was included in the TOCIVID-19 clinical trial (19 March 2020) and patients were moved to the clinical trial. During the off-label use period, 54 therapies were provided and 34 of these required a second dose. From an analysis of the epidemiological data, 80% of patients had at least one comorbidity and age over 75 years;60% were men. Death occurred in 6% overall, with a 30% death rate for patients over 75 years, according to national data. Conclusion and relevance The COVID-19 emergency has highlighted the pharmacist's role in the supply of innovative drugs and in the management of National Regulations. A close relationship with physicians has allowed sharing of views, focused on streamlining bureaucracy that often slows down the drug distribution process. Sharing opinions, bureaucratic streamlining and development of communications with online systems, web servers and phone chats can speed up the timing of organisation of the services.