Interdisciplinary Management of Cardiotoxicity in Outpatient Settings: A Survey on Practices, Perceptions and Potential for Improvement.

Abstract

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.