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Interdisciplinary Management of Cardiotoxicity in Outpatient Settings: A Survey on Practices, Perceptions and
Silvio Quick1, Lorena Payo-Anez1, Clara Marx Casimiro de Almeida1
1Department of Internal Medicine I, Cardiology, Angiology and Intensive Care, Klinikum Chemnitz gGmbH, Medical Campus Chemnitz of the TUD Dresden University of Technology Dresden, Germany.
Insights
Cardiotoxicity management in outpatient chemotherapy patients shows significant interdisciplinary gaps. Many specialists lack formal risk assessment and desire clearer guidelines, highlighting a need for improved cardio-oncology collaboration.
Area of Science:
- Cardio-oncology
- Oncology
- Cardiology
- Gynaecology
Background:
- Cardiotoxicity is a critical concern for patients receiving chemotherapy, necessitating collaborative management.
- Current management of chemotherapy-induced cardiotoxicity in outpatient settings may be inconsistent across specialties, potentially leading to care deficits.
Purpose of the Study:
- To assess the current practices and perceptions of cardiologists, oncologists, and gynaecologists regarding cardiotoxicity management in German outpatient chemotherapy patients.
Main Methods:
- An online questionnaire study was distributed to medical professionals.
- 132 cardiologists, oncologists, and gynaecologists participated, reporting on their management of 1,905 chemotherapy patients monthly.
Main Results:
- Only 37% of oncologist- and 48% of gynaecologist-treated patients received cardiology care.
- Just 37% of surveyed professionals routinely performed cardiovascular toxicity risk assessments.
- Over 50% requested simplified cardio-oncology guidelines and tools for risk assessment and management.
Conclusions:
- Significant interdisciplinary care gaps exist in managing cardiotoxicity during outpatient chemotherapy.
- Increased awareness, improved collaboration, and dedicated cardio-oncology networks are needed to address these issues and prevent undetected cardiotoxicity.
Background:
Cardiotoxicity is a major concern in patients undergoing chemotherapy, requiring interdisciplinary management. However, the extent to which cardiotoxicity is managed in the outpatient setting among these specialists may vary, potentially leading to gaps in patient care.
Methods:
This questionnaire study assessed the current practices and perceptions of cardiologists, oncologists and gynaecologists regarding the management of cardiotoxicity in patients undergoing outpatient chemotherapy in Germany.
Results:
A total of 1,329 medical professionals were contacted via an online questionnaire; 132 (9.9%) were included in the survey. The participants in our survey reported treating a total of 1,905 chemotherapy patients per month (range 1-200). Of these patients, only 37% of those treated by oncologists (n=13) and 48% of those treated by gynaecologists (n=53) received cardiological care. The results showed that 37% (49/132) of the healthcare professionals surveyed said they performed cardiovascular toxicity risk assessment of chemotherapy in their clinical practice. More than half of the participants (56%, 39/70) expressed a need for simplified cardio-oncology guidelines. The majority of participants (84% [59/70] and 83% [58/70], respectively) requested tools to assist in cardiovascular toxicity risk assessment and the implementation of appropriate therapeutic measures for patients undergoing chemotherapy.
Conclusion:
Our study underscores potential interdisciplinary care gaps, possibly increasing the risk of undetected cardiotoxicity. Variations in cardiotoxicity management among specialities highlight the need for increased awareness and improved collaboration. Interdisciplinary clinical pathways could address these issues, as could a dedicated cardio-oncology network for primary care physicians' support.
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