Oncologists' Perceptions of a Digital Tool to Improve Cancer Survivors' Cardiovascular Health

Kelley, Marjorie M.; Foraker, Randi E.; Lin, En-Ju D.; Kulkarni, Milind V.; Lustberg, Maryam B.; Weaver, Kathryn E.

doi:10.1055/s-0039-1696732

Cited by 11 publications

(11 citation statements)

References 68 publications

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“…Many studies focused on creating and evaluating mobile apps, typically aimed at addressing the needs of patients and consumers. These mobile apps focused on a variety of chronic diseases such as diabetes and hypertension [ 63 , 122 ], cardiovascular health [ 30 , 58 , 121 ], cancer care [ 58 , 127 ], mental health [ 13 , 23 , 25 , 57 , 110 ], seizure management [ 57 ], bladder monitoring [ 56 ], tuberculosis treatment [ 15 ], and parental education [ 40 , 41 ]. A small number of studies focused on telehealth [ 10 , 14 , 140 ] and personal health records or patient portals [ 38 , 109 , 141 ].…”

Section: Resultsmentioning

confidence: 99%

Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities

Marquard

2021

Yearb Med Inform

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Objective: Human factors and ergonomics (HF/E) frameworks and methods are becoming embedded in the health informatics community. There is now broad recognition that health informatics tools must account for the diverse needs, characteristics, and abilities of end users, as well as their context of use. The objective of this review is to synthesize the current nature and scope of HF/E integration into the health informatics community. Methods: Because the focus of this synthesis is on understanding the current integration of the HF/E and health informatics research communities, we manually reviewed all manuscripts published in primary HF/E and health informatics journals during 2020. Results: HF/E-focused health informatics studies included in this synthesis focused heavily on EHR customizations, specifically clinical decision support customizations and customized data displays, and on mobile health innovations. While HF/E methods aimed to jointly improve end user safety, performance, and satisfaction, most HF/E-focused health informatics studies measured only end user satisfaction. Conclusion: HF/E-focused health informatics researchers need to identify and communicate methodological standards specific to health informatics, to better synthesize findings across resource intensive HF/E-focused health informatics studies. Important gaps in the HF/E design and evaluation process should be addressed in future work, including support for technology development platforms and training programs so that health informatics designers are as diverse as end users.

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Section: Resultsmentioning

confidence: 99%

Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities

Marquard

2021

Yearb Med Inform

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“…Despite Institute of Medicine recommendations for adequate prevention efforts and care coordination for cancer survivors [ 13 - 15 ], cardiovascular risk continues to be undertreated in this population [ 16 , 17 ]. The majority of National Cancer Institute Community Oncology Research Program oncologists we interviewed (11 of 14) in a pilot study [ 18 ] reported cardiovascular health discussions to be “somewhat” or “very” important. Yet in general survivorship settings, few referrals for cardiovascular care are made by oncologists to primary care providers and cardiologists for guideline-driven follow-up care [ 11 , 16 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…Use of SPHERE resulted in improved BMI and diabetes status in the interventional primary care clinic but not the control clinic [ 31 ]. We refined this tool based upon feedback received from qualitative interviews with oncologists [ 18 ] and added information about receipt of potentially cardiotoxic cancer treatments. For this study, we evaluated the acceptability of the new Automated Heart-Health Assessment tool (AH-HA, Figure 1 ) among oncology providers and the Vigor-Us mobile app ( Figure 1 ) among breast cancer survivors.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Assessment Tool for Breast Cancer Survivors and Oncology Providers: Usability Study

Weaver¹,

Klepin²,

Wells³

et al. 2021

JMIR Cancer

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Background Cardiovascular health is of increasing concern to breast cancer survivors and their health care providers, as many survivors are more likely to die from cardiovascular disease than cancer. Implementing clinical decision support tools to address cardiovascular risk factor awareness in the oncology setting may enhance survivors’ attainment or maintenance of cardiovascular health. Objective We sought to evaluate survivors’ awareness of cardiovascular risk factors and examine the usability of a novel electronic health record enabled cardiovascular health tool from the perspective of both breast cancer survivors and oncology providers. Methods Breast cancer survivors (n=49) recruited from a survivorship clinic interacted with the cardiovascular health tool and completed pre and posttool assessments about cardiovascular health knowledge and perceptions of the tool. Oncologists, physician assistants, and nurse practitioners (n=20) who provide care to survivors also viewed the cardiovascular health tool and completed assessments of perceived usability and acceptability. Results Enrolled breast cancer survivors (84% White race, 4% Hispanic ethnicity) had been diagnosed 10.8 years ago (SD 6.0) with American Joint Committee on Cancer stage 0, I, or II (45/49, 92%). Prior to viewing the tool, 65% of survivors (32/49) reported not knowing their level for one or more cardiovascular health factors (range 0-4). On average, only 45% (range 0%-86%) of survivors’ known cardiovascular health factors were at an ideal level. More than 50% of survivors had ideal smoking status (45/48, 94%) or blood glucose level (29/45, 64%); meanwhile, less than 50% had ideal blood pressure (12/49, 24%), body mass index (12/49, 24%), cholesterol level (17/35, 49%), diet (7/49, 14%), and physical activity (10/49. 20%). More than 90% of survivors thought the tool was easy to understand (46/47, 98%), improved their understanding (43/47, 91%), and was helpful (45/47, 96%); overall, 94% (44/47 survivors) liked the tool. A majority of survivors (44/47, 94%) thought oncologists should discuss cardiovascular health during survivorship care. Most (12/20, 60%) oncology providers (female: 12/20, 60%; physicians: 14/20, 70%) had been practicing for more than 5 years. Most providers agreed the tool provided useful information (18/20, 90%), would help their effectiveness (18/20, 90%), was easy to use (20/20, 100%), and presented information in a useful format (19/20, 95%); and 85% of providers (17/20) reported they would use the tool most or all of the time when providing survivorship care. Conclusions These usability data demonstrate acceptability of a cardiovascular health clinical decision support tool in oncology practices. Oncology providers and breast cancer survivors would likely value the integration of such apps in survivorship care. By increasing awareness and communication regarding cardiovascular health, electronic health record–enabled tools may improve survivorship care delivery for breast cancer and ultimately patient outcomes.

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“…Claims data reveal that only 31–39% of breast cancer survivors received cholesterol screening, significantly fewer than matched women without breast cancer [ 7 ]. Ninety percent of oncologists we surveyed reported cardiovascular health (CVH) discussions to be “somewhat” or “very” important; however, 58% “rarely” or “sometimes” discuss CVH with their patients [ 8 ]. As a result, oncologists make few referrals for cardiovascular (CV) care to primary care and cardiology for guideline-driven follow-up care [ [9] , [10] , [11] , [12] ].…”

Section: Introductionmentioning

confidence: 99%

Addressing cancer survivors’ cardiovascular health using the automated heart health assessment (AH-HA) EHR tool: Initial protocol and modifications to address COVID-19 challenges

Foraker¹,

Davidson²,

Dressler³

et al. 2021

Contemporary Clinical Trials Communications

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Background The purpose of this paper is to describe the Automated Heart-Health Assessment (AH-HA) study protocol, which demonstrates an agile approach to cancer care delivery research. This study aims to assess the effect of a clinical decision support tool for cancer survivors on cardiovascular health (CVH) discussions, referrals, completed visits with primary care providers and cardiologists, and control of modifiable CVH factors and behaviors. The COVID-19 pandemic has caused widespread disruption to clinical trial accrual and operations. Studies conducted with potentially vulnerable populations, including cancer survivors, must shift towards virtual consent, data collection, and study visits to reduce risk for participants and study staff. Studies examining cancer care delivery innovations may also need to accommodate the increased use of virtual visits. Methods/design This group-randomized, mixed methods study will recruit 600 cancer survivors from 12 National Cancer Institute Community Oncology Research Program (NCORP) practices. Survivors at intervention sites will use the AH-HA tool with their oncology provider; survivors at usual care sites will complete routine survivorship visits. Outcomes will be measured immediately after the study visit, with follow-up at 6 and 12 months. The study was amended during the COVID-19 pandemic to allow for virtual consent, data collection, and intervention options, with the goal of minimizing participant-staff in-person contact and accommodating virtual survivorship visits. Conclusions Changes to the study protocol and procedures allow important cancer care delivery research to continue safely during the COVID-19 pandemic and give sites and survivors flexibility to conduct study activities in-person or remotely.

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Oncologists' Perceptions of a Digital Tool to Improve Cancer Survivors' Cardiovascular Health

Cited by 11 publications

References 68 publications

Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities

Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities

Cardiovascular Assessment Tool for Breast Cancer Survivors and Oncology Providers: Usability Study

Addressing cancer survivors’ cardiovascular health using the automated heart health assessment (AH-HA) EHR tool: Initial protocol and modifications to address COVID-19 challenges

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