An international survey of healthcare providers' knowledge of cardiac complications of cancer treatments.
Cardio-oncology
Cardio-toxicity
Cardiologists
Guidelines
Knowledge translation
Oncologists
Journal
Cardio-oncology (London, England)
ISSN: 2057-3804
Titre abrégé: Cardiooncology
Pays: England
ID NLM: 101689938
Informations de publication
Date de publication:
2019
2019
Historique:
received:
30
04
2019
accepted:
31
07
2019
entrez:
11
3
2020
pubmed:
11
3
2020
medline:
11
3
2020
Statut:
epublish
Résumé
Cardio-oncology is a young sub-specialty that addresses the needs of cancer patients at risk of, or who have experienced cancer therapy related cardiac dysfunction (CTRCD). This study assessed clinicians' understanding of cardio-oncology, opinions towards current practice, and approach to diagnosing and managing CTRCD. A 45-question survey was administered online via Survey Monkey and WeChat to health care providers (HCPs) comprising of cardiologists, oncologists, and others from September 2017 to March 2018. Implementation of the survey followed a modified Dillman's Total Design Method. In total, 160 responses were collected from 22 countries; majority were from cardiologists (53.8%) and oncologists (32.5%). The remaining 13.7% identified themselves as "others," including general internists, cardio-oncologists, pediatric oncologists, radiation oncologists, cardiac rehabilitation therapists, nurse practitioners, research students, and pharmacists. In the setting of metastatic cancer, there was a difference in risk tolerance for cardiotoxicity between subspecialties. In this case, more cardiologists (36.7%) accepted a 5-10% risk of cardiotoxicity compared to oncologists (20.0%). Majority of cardiologists felt that cardiotoxicity should be monitored, even in asymptomatic cancer patients (55.8%). Only 12% of oncologists selected this response. In contrast, 50.0% of oncologists reported that cardiologists should be involved only when patients develop cardiotoxicity. In comparison, 6.5% of cardiologists selected this response. Majority of cardiologists stated that cardio-oncology clinics would significantly improve cancer patients' prognosis (88.3%); only 45.8% of oncologists shared this opinion. Of all respondents, 66.9% stated they were familiar with a variety of international guidelines for managing cardiotoxicity. Of all oncologists, 65.3% indicated that they referred to these guidelines for clinical decision making. Despite the growth of cardio-oncology clinics, there are significant knowledge gaps regarding prevention and treatment strategies for CTRCD among health care providers. Knowledge translation from guidelines and collaboration between cardiologists and oncologists are needed to improve cardiovascular outcomes of cancer patients.
Sections du résumé
BACKGROUND
BACKGROUND
Cardio-oncology is a young sub-specialty that addresses the needs of cancer patients at risk of, or who have experienced cancer therapy related cardiac dysfunction (CTRCD). This study assessed clinicians' understanding of cardio-oncology, opinions towards current practice, and approach to diagnosing and managing CTRCD.
METHODS
METHODS
A 45-question survey was administered online via Survey Monkey and WeChat to health care providers (HCPs) comprising of cardiologists, oncologists, and others from September 2017 to March 2018. Implementation of the survey followed a modified Dillman's Total Design Method.
RESULTS
RESULTS
In total, 160 responses were collected from 22 countries; majority were from cardiologists (53.8%) and oncologists (32.5%). The remaining 13.7% identified themselves as "others," including general internists, cardio-oncologists, pediatric oncologists, radiation oncologists, cardiac rehabilitation therapists, nurse practitioners, research students, and pharmacists. In the setting of metastatic cancer, there was a difference in risk tolerance for cardiotoxicity between subspecialties. In this case, more cardiologists (36.7%) accepted a 5-10% risk of cardiotoxicity compared to oncologists (20.0%). Majority of cardiologists felt that cardiotoxicity should be monitored, even in asymptomatic cancer patients (55.8%). Only 12% of oncologists selected this response. In contrast, 50.0% of oncologists reported that cardiologists should be involved only when patients develop cardiotoxicity. In comparison, 6.5% of cardiologists selected this response. Majority of cardiologists stated that cardio-oncology clinics would significantly improve cancer patients' prognosis (88.3%); only 45.8% of oncologists shared this opinion. Of all respondents, 66.9% stated they were familiar with a variety of international guidelines for managing cardiotoxicity. Of all oncologists, 65.3% indicated that they referred to these guidelines for clinical decision making.
CONCLUSIONS
CONCLUSIONS
Despite the growth of cardio-oncology clinics, there are significant knowledge gaps regarding prevention and treatment strategies for CTRCD among health care providers. Knowledge translation from guidelines and collaboration between cardiologists and oncologists are needed to improve cardiovascular outcomes of cancer patients.
Identifiants
pubmed: 32154018
doi: 10.1186/s40959-019-0049-2
pii: 49
pmc: PMC7048147
doi:
Types de publication
Journal Article
Langues
eng
Pagination
12Informations de copyright
© The Author(s). 2019.
Déclaration de conflit d'intérêts
Competing interestsWe have read and understood Cardio-Oncology’s policy on disclosing conflicts of interest and declare that we have none.
Références
Br J Cancer. 1998 Mar;77(6):973-7
pubmed: 9528843
J Clin Oncol. 2017 Mar 10;35(8):870-877
pubmed: 27893331
J Oncol. 2015;2015:391848
pubmed: 26300916
Circulation. 2016 Mar 15;133(11):1104-14
pubmed: 26976915
Int J Cardiol. 2017 Aug 15;241:387-392
pubmed: 28365180
J Clin Oncol. 2017 Mar 10;35(8):893-911
pubmed: 27918725
Eur Heart J. 2016 Jun 1;37(21):1671-80
pubmed: 26903532
J Clin Oncol. 2005 Nov 1;23(31):7820-6
pubmed: 16258084
Curr Oncol. 2008 Jan;15(1):24-35
pubmed: 18317582
CA Cancer J Clin. 2016 Jul;66(4):309-25
pubmed: 26919165
Med Sci Monit. 2000 Mar-Apr;6(2):411-20
pubmed: 11208348
Curr Oncol Rep. 2016 Jun;18(6):35
pubmed: 27113369
Circulation. 2015 Jun 2;131(22):1981-8
pubmed: 25948538
Eur Rev Med Pharmacol Sci. 2018 Apr;22(7):2175-2185
pubmed: 29687878
Cancer Epidemiol Biomarkers Prev. 2013 Apr;22(4):561-70
pubmed: 23535024
Ann Oncol. 2012 Oct;23 Suppl 7:vii155-66
pubmed: 22997448
Can J Cardiol. 2016 Jul;32(7):831-41
pubmed: 27343741
Ther Adv Med Oncol. 2018 Jun 18;10:1758835918780140
pubmed: 29977352
Medicine (Baltimore). 2016 Nov;95(44):e5195
pubmed: 27858859
Br J Cancer. 2009 Mar 10;100(5):684-92
pubmed: 19259090
Eur Heart J. 2016 Sep 21;37(36):2768-2801
pubmed: 27567406
Crit Rev Oncol Hematol. 2018 Apr;124:1-10
pubmed: 29548480
Natl Vital Stat Rep. 2017 Nov;66(6):1-75
pubmed: 29235985
Breast Cancer Res. 2011 Jun 20;13(3):R64
pubmed: 21689398
Curr Pharm Des. 2010 Jan;16(1):3-10
pubmed: 20214614
Can Fam Physician. 1986 Nov;32:2366-8
pubmed: 21267217
Future Oncol. 2013 Feb;9(2):179-81
pubmed: 23414468
J Am Coll Cardiol. 2018 May 22;71(20):2281-2290
pubmed: 29540327
J Am Coll Cardiol. 2015 Jun 30;65(25):2739-46
pubmed: 26112199
J Clin Oncol. 2017 Mar 10;35(8):878-884
pubmed: 28199174
Eur J Cancer. 2013 Jul;49(10):2303-10
pubmed: 23583220