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Erschienen in: Journal of Cancer Survivorship 4/2020

10.02.2020 | Statins

Communicating cardiovascular risk to high-risk cancer survivors: a mixed-methods pilot study of a statin risk communication tool

verfasst von: Nirupa J. Raghunathan, Emily C. Zabor, Nassim Anderson, Kevin Oeffinger, Emily S. Tonorezos, Deborah Korenstein

Erschienen in: Journal of Cancer Survivorship | Ausgabe 4/2020

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Abstract

Purpose

Childhood, adolescent, and young adult cancer survivors treated with radiation therapy (RT) may be unaware of their high cardiovascular disease (CVD) risk or how to mitigate it. Tools are needed to improve understanding. We developed and pilot-tested a risk communication tool for shared decision-making with survivors regarding CVD risk reduction with statin therapy. We included quantitative and qualitative arms to further tool development and testing.

Methods

The statin risk communication tool was adapted from a previously validated tool. Patients were at increased risk for CVD due to history of chest RT and recruited to usual care and intervention arms. The post-visit survey included Likert-like scales to explore acceptability of the tool, knowledge questions, and a decisional conflict scale. This pilot study used descriptive statistics and was not powered for significance. Semi-structured interviews with intervention arm participants explored shared decision-making processes.

Results

Median participant (n = 46) age was 45. Most intervention patients (22/24, 92%) and 50% (11/22) of controls found statin information acceptable while 31% (7/22) of the control arm selected “not applicable” regarding information acceptability. Most participants were unaware of their personal CVD risk or potential statin side effects. In semi-structured interviews, participants found the tool is helpful to visualize risk and aid conversations.

Conclusions

The risk communication tool was acceptable. Qualitative data suggested the tool improved decisional clarity and comfort.

Implications for Cancer Survivors

Poor knowledge of CVD and statins and poor recall of CVD risk conversation suggest a need to continue to optimize conversations regarding cardiovascular risk and statin therapy.
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Literatur
3.
Zurück zum Zitat Heidenreich PA, Hancock SL, Lee BK, Mariscal CS, Schnittger I. Asymptomatic cardiac disease following mediastinal irradiation. J Am Coll Cardiol. 2003;42(4):743–9.CrossRef Heidenreich PA, Hancock SL, Lee BK, Mariscal CS, Schnittger I. Asymptomatic cardiac disease following mediastinal irradiation. J Am Coll Cardiol. 2003;42(4):743–9.CrossRef
4.
Zurück zum Zitat McEniery PT, Dorosti K, Schiavone WA, Pedrick TJ, Sheldon WC. Clinical and angiographic features of coronary artery disease after chest irradiation. Am J Cardiol. 1987;60(13):1020–4.CrossRef McEniery PT, Dorosti K, Schiavone WA, Pedrick TJ, Sheldon WC. Clinical and angiographic features of coronary artery disease after chest irradiation. Am J Cardiol. 1987;60(13):1020–4.CrossRef
9.
Zurück zum Zitat Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, et al. ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults—a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013, 2014;63(25_PA). https://doi.org/10.1016/j.jacc.2013.11.002. Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, et al. ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults—a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013, 2014;63(25_PA). https://​doi.​org/​10.​1016/​j.​jacc.​2013.​11.​002.
12.
Zurück zum Zitat Marlatt KL, Steinberger J, Rudser KD, Dengel DR, Sadak KT, Lee JL, et al. The effect of atorvastatin on vascular function and structure in young adult survivors of childhood cancer: a randomized, placebo-controlled pilot clinical trial. J Adolesc Young Adult Oncol. 2017. https://doi.org/10.1089/jayao.2017.0075. Marlatt KL, Steinberger J, Rudser KD, Dengel DR, Sadak KT, Lee JL, et al. The effect of atorvastatin on vascular function and structure in young adult survivors of childhood cancer: a randomized, placebo-controlled pilot clinical trial. J Adolesc Young Adult Oncol. 2017. https://​doi.​org/​10.​1089/​jayao.​2017.​0075.
16.
Zurück zum Zitat Wong ND, Young D, Zhao Y, Nguyen H, Caballes J, Khan I, et al. Prevalence of the American College of Cardiology/American Heart Association statin eligibility groups, statin use, and low-density lipoprotein cholesterol control in US adults using the National Health and Nutrition Examination Survey 2011-2012. J Clin Lipidol. 2016;10(5):1109–18. https://doi.org/10.1016/j.jacl.2016.06.011.CrossRefPubMed Wong ND, Young D, Zhao Y, Nguyen H, Caballes J, Khan I, et al. Prevalence of the American College of Cardiology/American Heart Association statin eligibility groups, statin use, and low-density lipoprotein cholesterol control in US adults using the National Health and Nutrition Examination Survey 2011-2012. J Clin Lipidol. 2016;10(5):1109–18. https://​doi.​org/​10.​1016/​j.​jacl.​2016.​06.​011.CrossRefPubMed
17.
Zurück zum Zitat Institute of Medicine Committee on Quality of Health Care in A. Crossing the quality chasm: a new health system for the 21st century. Washington (DC): National Academies Press (US); 2001. Institute of Medicine Committee on Quality of Health Care in A. Crossing the quality chasm: a new health system for the 21st century. Washington (DC): National Academies Press (US); 2001.
Metadaten
Titel
Communicating cardiovascular risk to high-risk cancer survivors: a mixed-methods pilot study of a statin risk communication tool
verfasst von
Nirupa J. Raghunathan
Emily C. Zabor
Nassim Anderson
Kevin Oeffinger
Emily S. Tonorezos
Deborah Korenstein
Publikationsdatum
10.02.2020
Verlag
Springer US
Schlagwort
Statins
Erschienen in
Journal of Cancer Survivorship / Ausgabe 4/2020
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-020-00860-4

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