Abstract
Aims: Women diagnosed with breast cancer are at increased risk of cardiovascular disease (CVD), due the combination of anti-cancer treatments and pre-existing modifiable CVD risk factors. Cancer treatment is often associate with limited attention to risk factor management. This study aimed to investigate feasibility of reducing the impact of CVD after breast cancer using a nurse led ‘Heart in Breast Cancer’ intervention to address modifiable risk factors.
Methods: This study used a single-arm pilot implementation trial design. Women with early-stage breast cancer commencing systemic cancer treatment were invited to attend a nurse-led cardio-oncology clinic where they were provided with information/recommendations and developed individualised goals for self-management of modifiable risk factors, including physical activity, diet, smoking, and alcohol use. They were reassessed at 12 weeks. Feasibility was assessed as adherence to: (a) appointments/assessments; and (b) recommended interventions. Preliminary efficacy in impacting modifiable risk factors was analysed continuously (Wilcoxon’s signed rank test) and categorically McNemar’s test).
Results: Of 50 women approached, 42 (84%; median age=58.5) attended initial assessment, 39 (92.9%) of whom completed followup. Recommendations/goals were made to increase physical activity with 29 (69%) participants, of whom 21 (72.4%) made corresponding improvements; change diet with 28 (66.6%) participants, of whom 14 (50%) made improvements; and reduce smoking with 6 (14.3%) participants, of whom 2 (33.3%) made improvements. Of two participants with high alcohol consumption, one made no improvement; the other did not attend followup. Increases in physical activity levels and vegetable consumption were significant (p<.05) in at-risk sub-samples.
Conclusions: This pilot study demonstrated high recruitment and attendance and improvements in commonly identified CVD risk factors (i.e., physical activity and vegetable consumption), with variable improvements for other risk factors (e.g., smoking). Future practice and research should address readiness/capacity to change during anticancer treatment, available referral pathways, control comparison and longer follow-up.
Methods: This study used a single-arm pilot implementation trial design. Women with early-stage breast cancer commencing systemic cancer treatment were invited to attend a nurse-led cardio-oncology clinic where they were provided with information/recommendations and developed individualised goals for self-management of modifiable risk factors, including physical activity, diet, smoking, and alcohol use. They were reassessed at 12 weeks. Feasibility was assessed as adherence to: (a) appointments/assessments; and (b) recommended interventions. Preliminary efficacy in impacting modifiable risk factors was analysed continuously (Wilcoxon’s signed rank test) and categorically McNemar’s test).
Results: Of 50 women approached, 42 (84%; median age=58.5) attended initial assessment, 39 (92.9%) of whom completed followup. Recommendations/goals were made to increase physical activity with 29 (69%) participants, of whom 21 (72.4%) made corresponding improvements; change diet with 28 (66.6%) participants, of whom 14 (50%) made improvements; and reduce smoking with 6 (14.3%) participants, of whom 2 (33.3%) made improvements. Of two participants with high alcohol consumption, one made no improvement; the other did not attend followup. Increases in physical activity levels and vegetable consumption were significant (p<.05) in at-risk sub-samples.
Conclusions: This pilot study demonstrated high recruitment and attendance and improvements in commonly identified CVD risk factors (i.e., physical activity and vegetable consumption), with variable improvements for other risk factors (e.g., smoking). Future practice and research should address readiness/capacity to change during anticancer treatment, available referral pathways, control comparison and longer follow-up.
| Original language | English |
|---|---|
| Pages | 33-33 |
| Number of pages | 1 |
| Publication status | Published - 2022 |
| Event | 4th Victorian Cancer Survivorship Conference: Shifting Gears: Rethinking survivorship - Virtual conference Duration: 24 Mar 2022 → 25 Mar 2022 Conference number: 4th |
Conference
| Conference | 4th Victorian Cancer Survivorship Conference |
|---|---|
| City | Virtual conference |
| Period | 24/03/22 → 25/03/22 |
| Other | Our conference theme Shifting Gears: Rethinking Survivorship will consider how recent advances in cancer survivorship research and care can be adopted, as well as consider future system transformation, to better meet the needs of the growing survivorship population. We will particularly recognise changes as a result of the COVID-19 pandemic. |
Keywords
- Breast cancer
- Cardiovascular disease (CVD)
- Risk factor management
- Nurse led care
