Abstract
Aims: Many cancers share risk factors with cardiovascular disease (CVD), and treatments for common cancers, including breast, prostate, and haematological cancers, can substantially increase CVD risk. However, little is known regarding preferred models of care to address these risks. This study reports on an umbrella review and co-design process to develop a nurse-led clinical intervention to manage CVD risks in people with cancer.
Methods: A systematic umbrella review of interventions to manage CVD in cancer was combined with stakeholder consultation (focus groups and individual interviews) with consumers, health professionals, and non-government organisation representatives, to inform a nurse-led clinical pathway for management of CVD.
Results: The most consistent evidence found in included reviews/meta-analyses (n=14) was for pharmaceutical and exercise interventions; however, little information was provided on the ‘who and how’ of implementation to inform a model of care. Our stakeholder consultation included consumers, and health professionals across oncology, haematology, cardiology, general practice, and nongovernment services (n=47 participants). Most consumers experienced a lack of awareness/discussion of CVD risks associated with cancer and treatment, while health professionals identified the need for effective clinical pathways to address these risks. Stakeholder views on the roles of treating oncologists/haematologists and GPs varied; some saw CVD management for people with cancer as core business for these professionals, while others considered it outside of scope of practice/ expertise, or impractical due to time limitations. Most preferred a specialist cardiologist to manage existing CVD, but preferred other professionals for early education, assessment, and risk management. General support was found for a specialist nurse to perform these roles using a three-tiered assessment and management model.
Conclusions: We found limited review-level evidence for effective models of care for the management of CVD risk in cancer; although stakeholders favoured nurse-led models. Further research is needed to investigate implementation and effectiveness of interventions to evaluate and monitor the risk of cardiotoxicity from cancer treatment.
Methods: A systematic umbrella review of interventions to manage CVD in cancer was combined with stakeholder consultation (focus groups and individual interviews) with consumers, health professionals, and non-government organisation representatives, to inform a nurse-led clinical pathway for management of CVD.
Results: The most consistent evidence found in included reviews/meta-analyses (n=14) was for pharmaceutical and exercise interventions; however, little information was provided on the ‘who and how’ of implementation to inform a model of care. Our stakeholder consultation included consumers, and health professionals across oncology, haematology, cardiology, general practice, and nongovernment services (n=47 participants). Most consumers experienced a lack of awareness/discussion of CVD risks associated with cancer and treatment, while health professionals identified the need for effective clinical pathways to address these risks. Stakeholder views on the roles of treating oncologists/haematologists and GPs varied; some saw CVD management for people with cancer as core business for these professionals, while others considered it outside of scope of practice/ expertise, or impractical due to time limitations. Most preferred a specialist cardiologist to manage existing CVD, but preferred other professionals for early education, assessment, and risk management. General support was found for a specialist nurse to perform these roles using a three-tiered assessment and management model.
Conclusions: We found limited review-level evidence for effective models of care for the management of CVD risk in cancer; although stakeholders favoured nurse-led models. Further research is needed to investigate implementation and effectiveness of interventions to evaluate and monitor the risk of cardiotoxicity from cancer treatment.
| Original language | English |
|---|---|
| Pages | 51 |
| Number of pages | 1 |
| Publication status | Published - Mar 2021 |
| Event | Clinical Oncology Society of Australia & Flinders University Cancer Survivorship Conference 2021 - Virtual conference Duration: 18 Mar 2021 → 19 Mar 2021 |
Conference
| Conference | Clinical Oncology Society of Australia & Flinders University Cancer Survivorship Conference 2021 |
|---|---|
| Period | 18/03/21 → 19/03/21 |
Keywords
- Cancer
- Cardiovascular disease
- Risk factors
- Patient outcomes
